title: Effectiveness of a clinical pathway for the diagnosis and treatment of dementia and for the education of families.
abstract: OBJECTIVE
  Clinical pathways (CPs) are rarely used in the treatment of dementia. We established a CP for a series of medical practices (diagnosis, treatment, establishment of a care system, and caregiver education) for patients with dementia hospitalized for a three-week period, and evaluated its usefulness.
  
  
  METHODS
  The length of hospital stay and hospital costs were compared between 23 consecutive patients with dementia hospitalized and treated using a CP and 20 controls treated by conventional medical practice without using a CP in a special ward for dementia patients. In the CP group, at the time of discharge, primary caregivers, physicians, and nurses were given a questionnaire to obtain their comments about the impression of treatment with the CP.
  
  
  RESULTS
  The questionnaire survey indicated that the CP deepened the caregiver's understanding of the sequence of medical practices for the inpatient, the disorders of the inpatient, the treatment methods, and the methods for coping with the disorder. The CP was also useful for facilitating inpatient medical practice and promoting the establishment of a care system after discharge. The use of the CP significantly shortened the length of hospital stay and decreased hospital costs during hospitalization but increased the amount of work per day and made the medical staff feel that their freedom to choose medical procedures had been restricted.
  
  
  CONCLUSIONS
  The CP was useful for execution of inpatient medical practices for patients with dementia.
authors.affiliation: Psychiatry and Behavioral Science, Osaka University Graduate School of Medicine, Japan. kazui@psy.med.osaka-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kazui
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamamura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nagaoka
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Endo
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Tokunaga
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ikejiri
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000368:Aged; D017028:Caregivers / Q000193:education*; D019091:Critical Pathways; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy*; D005190:Family; D005260:Female; D006266:Health Education / Q000379:methods*; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D007564:Japan; D007902:Length of Stay; D008297:Male; D016896:Treatment Outcome