title: [Effect of clinical pathways based on integrative medicine for patients with chronic heart failure: a multi-center research].
abstract: OBJECTIVE
  To assess a multi-center study effectiveness of clinical pathways based on integrative medicine (IM) for chronic heart failure (CHF) patients.
  
  
  METHODS
  A combined method of historical control study and clinical study on concurrent control was used. After the standard management for clinical pathways was carried out in four hospitals at home, the effects on hospitalization days, medical expenses, clinical efficacy, patient satisfaction, and quality of life were assessed.
  
  
  RESULTS
  Results of non-concurrent historical control study showed that: the hospital stay was significantly shorter in the pathways group than in the retrospective group (12.59 days vs 18.44 days), and the total cost of hospitalization was significantly reduced in the pathways group (yen 9 051.90 vs yen 11 978.40), showing statistical difference (P < 0.01). Moreover, the effect on the heart function was better in the pathways group than in the retrospective group (the markedly effective rate: 45.60% vs 21.90%; the total effective rate: 96.80% vs 86.10%), showing statistical difference (P < 0.01). Results of clinical study on concurrent control showed that the hospital stay was significantly shorter in the pathways group than in the control group (11.19 days vs 13.21 days), showing statistical difference (P < 0.05). The average total cost of hospitalization was significantly lower in the pathways group than in the control group (yen 8 656.80 vs yen 11 609.70), showing statistical difference (P < 0.01). As for clinical efficacy of Chinese medical syndrome, the total effective rate was higher in the pathways group than in the control group (97.10% vs 93.62%), showing statistical difference (P < 0.05). The markedly effective rate of heart function was better in the pathways group than in the control group, showing statistical difference (49.30% vs 38.30%, P < 0.05). The overall satisfaction was higher in the pathways group than in the conventional group (P < 0.01). There was no statistical difference in the mortality within 3 months after discharge from hospital, and the readmission rate due to heart failure between the two groups (P > 0.05). But there was statistical difference in the quality of life (P < 0.05).
  
  
  CONCLUSIONS
  The pathway could shorten the hospitalization time, decrease the cost of hospitalization, improve the clinical efficacy, improve patients' quality of life and satisfaction, therefore, it could be spread nationwide.
authors: Department of Cardiovascular Diseases, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China.
authors: Xu
authors: X
authors: Zou
authors: Guang-Ming
authors: GM
authors: Pan
authors: Xiao-Gang
authors: XG
authors: Sheng
authors: Geng-Zhen
authors: GZ
authors: Yao
authors: Ming-Jun
authors: MJ
authors: Zhu
authors: Yang
authors: Y
authors: Wu
authors: Xiao-Hu
authors: XH
authors: Chen
authors: Yong-Xia
authors: YX
authors: Wang
authors: Jie
authors: J
authors: Cui
authors: Jian-Dong
authors: JD
authors: Chen
mesh_terms: D002908:Chronic Disease; D019091:Critical Pathways; D006333:Heart Failure / Q000451:nursing* / Q000628:therapy*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D055048:Integrative Medicine; D007902:Length of Stay; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome