The role of a clinical pathway in curtailing unnecessary investigations in children with gastroenteritis.
Am J Med Qual
; 20(2): 83-9, 2005.
Article
en En
| MEDLINE
| ID: mdl-15851386
ABSTRACT
Clinical pathways are useful tools in improving the quality of care of patients treated in hospitals. Gastroenteritis is a short, self-limiting, but common illness of childhood associated with significant costs to the community. The authors assessed the impact of a clinical pathway on investigation ordering in children with gastroenteritis. A retrospective analysis of 2 cohorts of children was performed before (n=1498) and after (n=1252) the introduction of a clinical pathway. Children admitted to hospital with a diagnosis of gastroenteritis were assessed as to the type of pathology tests ordered. Further outcomes measured were rates of admission, emergency department presentations, average length of stay, and direct costs. Subset analysis was undertaken on the initial cohort of patients who had a full blood count as part of their initial assessment. Full blood count was more likely to be performed prior to the introduction of the pathway(77.1%) than after pathway introduction (66.8%; P<.004). Urine microscopy and culture also was significantly decreased from 56.3% to 40.4% (P<.0005). Median patient costs were reduced from $1228 to $752 following pathway introduction (P<.0001); however, rates of admission were increased from 18.6% to 28.8% (P<.0001). Length of stay decreased but was not statistically significant. Full blood count results in the subset analysis revealed that the measurement of a full blood count had no impact on management. Thus, a clinical pathway contributed to more rational ordering of pathology tests and lowered the costs to a hospital of caring for patients with this common illness.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
/
2_ODS3
Problema de salud:
11_delivery_arrangements
/
2_enfermedades_transmissibles
Asunto principal:
Calidad de la Atención de Salud
/
Vías Clínicas
/
Gastroenteritis
Tipo de estudio:
Guideline
/
Observational_studies
/
Risk_factors_studies
Límite:
Child, preschool
/
Female
/
Humans
/
Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Am J Med Qual
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2005
Tipo del documento:
Article
País de afiliación:
Australia