title: [Effect of clinical pathway management on pediatric pneumonia].
abstract: OBJECTIVE
  To investigate effect of clinical pathway management on pediatric pneumonia.
  
  
  METHODS
  Data were colleted from children hospitalizated with bronchial pneumonia, bronchiolitis, mycoplasma pneumonia in Center of Respiratory Disorders in Children's Hospital of Chongqing Medical University from January 2011 to December 2012. According to implement of clinical pathway management, all patients were divided into pathway management group (n = 405) and non-pathway management group (n = 503). Length of stay, costs of hospitalization, clinical effect and use of antibiotics were compared in these two groups.
  
  
  RESULTS
  In pathway management group, average length of stay of children with bronchial pneumonia and bronchiolitis was (6.1 ± 1.6) d and (6.2 ± 1.5) d respectively. While in non-pathway management group, length of stay was (7.2 ± 1.9) d and (7.3 ± 1.5) d (P = 0.000). There was no significant difference in length of stay between these two groups of children with mycoplasma pneumonia [ (6.9 ± 1.8) d vs.(7.7 ± 2.5) d] (P = 0.198). Costs of auxiliary tests in pathway management group was slightly higher than that in non-pathway management group. While other costs in pathway management group were significantly lower than those in non-pathway management group. Total costs of hospitalization of patients with these three diseases in pathway management group and non-pathway management group were ¥(4609 ± 1225) vs ¥ (5629 ± 1813) , ¥ (5006 ± 1250) vs. ¥ (5686 ± 1337), ¥ (4946 ± 1259) vs. ¥ (6488 ± 3032) respectively. There was a significant difference (P < 0.05). Percentages of antibiotics use in two groups were 70.9% vs.99.4%, 45.7% vs.93.4% and 96.2% vs.100.0%. Antibiotics related indicators such as mean number of day of use, ratio of combination and grade of antibiotics were significantly higher in pathway management group compared to non-pathway management group (P < 0.01). There was no significant difference in other indicators like clinical effect and unscheduled readmission in 30 days between two groups (P > 0.05).
  
  
  CONCLUSIONS
  Clinical pathway management can regulate medical behaviors through reduction of medical costs, avoidance of excessive laboratory tests and therapy, and regulation of antibiotic use.
authors.affiliation: Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
authors.forename: Li-juan
authors.initials: LJ
authors.lastname: Yin
authors.affiliation: Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
authors.forename: Dong-hong
authors.initials: DH
authors.lastname: Peng
authors.affiliation: Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China. Email: danieljh@163.com.
authors.forename: Ji-hong
authors.initials: JH
authors.lastname: Dai
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000191:economics / Q000628:therapy; D003363:Cost Control; D019091:Critical Pathways; D005260:Female; D006739:Hospital Administration; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000191:economics; D008297:Male; D011014:Pneumonia / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy / Q000191:economics / Q000628:therapy; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents