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[Effect of clinical pathways based on integrative medicine for patients with chronic heart failure: a multi-center
Xu Zou1, Guang-Ming Pan, Xiao-Gang Sheng
1Department of Cardiovascular Diseases, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China.
Insights
Integrative medicine (IM) clinical pathways significantly reduced hospital stays and costs for chronic heart failure (CHF) patients. These pathways also improved clinical efficacy, patient satisfaction, and quality of life, supporting nationwide adoption.
Area of Science:
- Integrative Medicine
- Cardiology
- Health Services Research
Context:
- Chronic heart failure (CHF) poses a significant burden on healthcare systems globally.
- Optimizing patient management and resource utilization is crucial for improving outcomes in CHF care.
- Clinical pathways offer a standardized approach to patient management, but their effectiveness in integrative medicine settings for CHF requires evaluation.
Purpose:
- To evaluate the effectiveness of multi-center clinical pathways incorporating integrative medicine (IM) for patients with chronic heart failure (CHF).
- To assess the impact of IM-based clinical pathways on hospitalization duration, medical expenses, clinical efficacy, patient satisfaction, and quality of life.
Summary:
- A multi-center study utilized historical and concurrent control groups to assess IM-based clinical pathways for CHF patients.
- Results demonstrated significantly shorter hospital stays and reduced hospitalization costs in the pathway groups compared to control groups.
- The pathways also showed improved heart function efficacy, higher patient satisfaction, and enhanced quality of life.
Impact:
- IM-based clinical pathways offer a promising model for improving the management of chronic heart failure.
- The findings suggest that these pathways can lead to significant cost savings and better patient outcomes.
- The study supports the nationwide implementation of integrative medicine clinical pathways for CHF patients to enhance care quality and efficiency.
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).
Conclusion:
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.
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