The association between clinical pathways and hospital length of stay: a case study.
Clinical pathways are the treatment protocol in order to reduce or eliminate variation of care by specifying to nursing and medical staff. The effectiveness of the clinical pathways to accomplish this goal, however, is in question. With the implementation of the clinical pathways in 2001, this study evaluates the effectiveness of clinical pathway in reducing the inpatient length of stay in a rural hospital in a Midwestern state. All inpatient cases were used with the primary diagnoses of chronic obstructive pulmonary disease, congestive heart failure, diabetes, myocardial infarction, and pneumonia from the years of 1999-2003. By controlling for gender, age, insurance type, and year, this study employs a multiple regression analysis to evaluate the association between clinical pathways and the length of stay. Only one (the clinical pathway for myocardial infarction) out of the five pathways studied showed an association with a statistical significance in decreasing the length of stay. Health care administrators should consider other aspects as well as the hospital length of stays when implementing clinical pathways in their facility.
Lee
Keon-Hyung
KH
Health Services Administration Program, Department of Health Professions, College of Health and Public Affairs, University of Central Florida, Orlando 32816, USA. keonlee@mail.ucf.edu
Anderson
Yvonne M
YM
D000368:Aged; D019091:Critical Pathways; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D011014:Pneumonia / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012044:Regression Analysis; D014600:Utilization Review