[Evaluation of the application of the clinical pathway using Diagnosis Procedure Combination (DPC) data]

The clinical pathway (CP) is a schedule of a standard set of treatments for a particular clinical condition. The horizontal axis of the CP indicates hospitalization days and the vertical axis indicates a set of procedures for each day. Using the CP, medical staff (i.e., physicians and nurses) and patients can have a clear image of the content of treatment and its schedule, and can understand the tests, operation schedules and the aim of the discharge day, and avoid excessive or deficient tests and care. The health care service can function smoothly as a team because it is clear who is responsible for what. However, it requires a considerable amount of time and work for medical staff to evaluate clinical activities based on the established CP, to monitor the appropriateness of the CP, and to modify its content if necessary. Because of this, it is not rare for hospital staff to stop using CPs. In this study, we tried to develop a method to systematically evaluate the appropriate level of CP based on Diagnosis Procedure Combination (DPC) data. Furthermore, we developed a methodology to formulate a new CP based on DPC data. The present study has clarified that management staff can support medical staff in CP - based clinical evaluation and CP development by using the DPC data. This kind of partnership between management and medical staffs should contribute to the standardization and amelioration of clinical quality.