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[Effect of clinical pathway management on pediatric pneumonia]
Yang Yang1, Li-juan Yin1, Dong-hong Peng1
1Center of Respiratory Disorders, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
Insights
Clinical pathway management for pediatric pneumonia reduced hospitalization costs and length of stay for certain types, while optimizing antibiotic use. This approach regulates medical behaviors by lowering expenses and avoiding unnecessary tests and therapies.
Area of Science:
- Pediatric Respiratory Medicine
- Healthcare Management
- Clinical Pathways
Context:
- Pediatric pneumonia presents a significant healthcare burden.
- Effective management strategies are crucial for optimizing patient outcomes and resource utilization.
- Clinical pathway management offers a structured approach to standardize care.
Purpose:
- To evaluate the impact of clinical pathway management on pediatric pneumonia treatment.
- To compare length of stay, hospitalization costs, clinical outcomes, and antibiotic usage between pathway and non-pathway groups.
- To assess the effectiveness of clinical pathways in regulating medical behaviors.
Summary:
- A study compared 405 children managed with clinical pathways to 503 without, for bronchial pneumonia, bronchiolitis, and mycoplasma pneumonia.
- Pathway management significantly reduced length of stay for bronchial pneumonia and bronchiolitis, and lowered overall hospitalization costs.
- While antibiotic use indicators were higher in the pathway group, overall costs decreased, and clinical effects remained comparable.
Impact:
- Clinical pathway implementation can lead to substantial cost savings in pediatric pneumonia care.
- Standardized pathways help regulate medical behaviors, reducing unnecessary laboratory tests and therapies.
- This approach demonstrates potential for improving efficiency in pediatric respiratory disorder management.
Objective:
To investigate effect of clinical pathway management on pediatric pneumonia.
Method:
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.
Result:
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).
Conclusion:
Clinical pathway management can regulate medical behaviors through reduction of medical costs, avoidance of excessive laboratory tests and therapy, and regulation of antibiotic use.
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