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P013 A preliminary analysis of the clinical pathways in China
  1. M Wei,
  2. M Liu
  1. Sichuan University, West China Hospital, Chinese Evidence Based Medicine Center, Chengdu, China

Abstract

Background Clinical pathway (CP) is an application of rational process and time management for specific disease and surgery in practice. The CP was firstly introduced into China in 1990s.

Objective To find the current status of clinical pathways in China.

Methods We used word clinical pathway in title by searching the web of clinical pathway (www.ch-cp.org.cn), CNKI, etc. and collected CP on title, date, specialties and main contents, etc. Search date till July 30, 2012.

Results 1) 331 CPs were issued in 2009-2011, 25,503 departments from 3,467 hospitals conducted CP and public hospital accounted for 46.9% by 2011 in China. 2) The CPs was pilot implemented in 110 selected hospitals from 23 provinces on 22 specialties, such as general surgery, cardiovascular, orthopaedics, etc. 3) The contents of CP mainly include: disease and target population, diagnosis, treatment option, standard length of stay in hospital, criteria for CP entrance, preoperative evaluation, time and choice for use of prophylactic antibiotics, operation day, postoperative hospital stay recovery, discharge standard, variance and reason analysis, etc. Few CP described the sources of funding, composition of group that authored the CP and financial disclosures. 4) The major influential factors of CP implementation include: the participation of doctors and patients, explanation of the various process and documents, payment problems, hospital management, appropriate incentive mechanisms, information systems and other support policies, etc.

Conclusions Clinical pathway may a tool for hospital quality management and assessment criteria of disease effectiveness-costs. More communications with doctors and patients and innovative payment methods would be better for CP implementation.

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