Abstract:

Objective To evaluate the implementation effect of clinical pathway for shingles and to propose corresponding policies. Methods A total of 1 044 patients with shingles were selected and divided into two groups according to whether the clinical pathway was implemented, i.e. the control group (n=343) and the clinical pathway group (n=701). The differences of average hospitalization days, total hospitalization expenses per capita, and cost and ratio per unit of two groups were compared. Case interviews with relevant administrators and medical staff were also carried out. Results The major influence factors of the total hospitalization expenses were the proportion of drug expenses, nursing expenses, hospitalization days, and consultation fees (r=0.867, 0.760, 0.747, and 0.747, P=0.000). Compared to the control group, the hospitalization days of the clinical pathway group were 1.03 days fewer and the total hospitalization expense per capita was 312.68 yuan cheaper. The differences were statistically significant (P=0.003 and P=0.045). The drugs expenses, consultation fees, bed fee, and examination fees were all significantly reduced (P<0.05 or P<0.01). Administrators and medical staff generally believed that the clinical pathway benefited the doctor-patient relationship, but increased the workload. Conclusion Wider implementation and continuous improvement of clinical pathway should be fully supported and corresponding policies should be perfected. The clinical pathway forms require further elaboration and optimization and the medical resources need to be allocated reasonably. Relevant incentive measures should be made so as to improve the enthusiasm of clinical and administrative staff.

Key words: shingles, clinical pathway, single disease, implementation effect