This article elaborates the concept, meaning and role of clinical pathway, discusses development stages and implementation effects of clinical pathway at home and abroad, and proposes that clinical pathway has been developed very well abroad, but it still has many problems in domestic gtowth which needs to be put into effect with Single-DRGs system in combination.
ObjectiveTo explore the effectiveness of clinical pathway (CP) in patients underwent laparoscopic cholecystectomy (LC). MethodsA retrospective, case-matched, and clinical controlled study was applied. We selected patients with acute calculous cholecystitis (ACC) who were hospitalized in 363 Hospital and underwent LC between September 2012 and August 2013, and divided them into two groups (non-CP vs. CP:2 to 1) according to sex, age (±5), nation and complications. The indicators including length of stay (LOS), antibiotic usage and per-average hospital expenses were compared between groups. Data were analyzed using SPSS 13.0 software. ResultsA total of 1 044 patients were included, of which 348 were assigned to CP management (CP group), while the other 696 patients were 2 to 1 matched with those in the CP group. Compared to the non-CP group, the pre-operation LOS and total LOS in the CP group were shortened by 1.23 days and 2.08 days, respectively (P < 0.05); the per-average hospital expenses and per-average expenses of drugs in the CP group were decreased by ￥604.7 yuan and ￥287.5 yuan, respectively (P < 0.05); and the rate of antibiotic and non-restricted antibiotic usage in the CP group were dropped by 4.4% and 7.0%, respectively (P < 0.05). There was no significant difference between the groups in efficiency, hospital-related infection rate, the incidence of adverse events, the restricted and special antibiotic usage rate (P > 0.05). The variation coefficient of patients included in the CP group was 15.8%, and the time which did not meet the admission requirement of CP was the main reason for this variation (27, 49.1%). ConclusionClinical pathway could shorten the LOS and cut down the total hospital expenses. However, multidisciplinary cooperation is still needed, and we should optimize the CP processes continuously and enhance the flexibility of CP, so as to improve the quality of medical service.