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Open Access 02-04-2024 | Review Article

The effectiveness of clinical pathways in inpatient settings - an umbrella review

Authors: Anne Büscher, Joachim Kugler

Published in: Journal of Public Health

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Abstract

Aim

The aim of this research is to summarize the effectiveness of clinical pathways in inpatient settings in industrialized countries to gain implications for hospital management or identify further research needs.

Subject and methods

Systematic literature reviews and meta-analyses published in English from 2010 to August 30, 2023, investigating the effectiveness of clinical inpatient pathways are identified, summarized, and synthesized. PubMed, Cochrane Library, and MEDLINE databases were searched.

Results

The search identified a total of ten systematic reviews, of which seven also conducted meta-analyses. The results show substantial heterogeneity in the data. In total, data from 140 primary studies are included. The parameters that were most frequently examined are complication rates, impact on length of stay, readmission rates, mortality, documentation quality, and hospital and care costs.

Conclusion

A positive impact of clinical pathways, including a reduced risk of complications, reduced length of stay, and a better documentation quality, can be summarized. However, the definition of the concept of clinical pathways already differs and the outcomes that were examined also differ in their definition and measurement. The results of this research on clinical pathways are not sufficient for transfer to the current situation. The results show an added value for patients, staff, and relatives, particularly for clinical pathways that involve frequent illnesses, are cost-intensive, and require a lot of communication between different professionals. Furthermore, it can be concluded that further research with randomized controlled trials is necessary to investigate the effectiveness of clinical pathways.
Literature
go back to reference Chawla A, Westrich K, Matter S, Kaltenboeck A, Dubois R (2016) Care pathways in US healtcare settings: current successes and limitations, and future challenges. Am J Manag Care 22:53–62PubMed Chawla A, Westrich K, Matter S, Kaltenboeck A, Dubois R (2016) Care pathways in US healtcare settings: current successes and limitations, and future challenges. Am J Manag Care 22:53–62PubMed
go back to reference Manteuffel L (2020) Rehabilitation: Messbarer Patientennutzen als Ziel. Dtsch Arztebl 117(9): A-434 / B-380 / C-366 Manteuffel L (2020) Rehabilitation: Messbarer Patientennutzen als Ziel. Dtsch Arztebl 117(9): A-434 / B-380 / C-366
go back to reference Rau F, Roeder N, Hensen P (2009) Zum Stand der deutschen DRG-Einführung: Erkenntnisse, Erfahrungen und Meinungen. In: Rau F, Roeder N, Hensen P (eds) Auswirkungen der DRG-Einführung in Deutschland - Standortbestimmung und Perspektiven. Kohlhammer, Stuttgart, pp 9–18CrossRef Rau F, Roeder N, Hensen P (2009) Zum Stand der deutschen DRG-Einführung: Erkenntnisse, Erfahrungen und Meinungen. In: Rau F, Roeder N, Hensen P (eds) Auswirkungen der DRG-Einführung in Deutschland - Standortbestimmung und Perspektiven. Kohlhammer, Stuttgart, pp 9–18CrossRef
go back to reference Romiti GF, Patori D, Rivera-Carvaca JM, Yew Ding W, Xuan Gue Y, Menichelli D, Gumprecht J, Koziel M, Yang P-S, Guo Y, Lip GYH, Proietti M (2022) Adherence to the ‘atrial fibrillation better care’ pathway in patients with atrial fibrillation: impact on clinical outcomes—a systematic review and meta-analysis of 285,000 patients. Thromb Haemost 122:406–414. https://doi.org/10.1055/a-1515-9630CrossRefPubMed Romiti GF, Patori D, Rivera-Carvaca JM, Yew Ding W, Xuan Gue Y, Menichelli D, Gumprecht J, Koziel M, Yang P-S, Guo Y, Lip GYH, Proietti M (2022) Adherence to the ‘atrial fibrillation better care’ pathway in patients with atrial fibrillation: impact on clinical outcomes—a systematic review and meta-analysis of 285,000 patients. Thromb Haemost 122:406–414. https://​doi.​org/​10.​1055/​a-1515-9630CrossRefPubMed
go back to reference Rotter T, Baatenburg de Jong R, Lacko S E, Ronellenfitsch U, Kinsman L (2019) Chapter 12: Clinical pathways as a quality strategy. In Busse R, Klazinga N, Panteli D, Quentin W, Improving healthcare quality in Europe: characteristics, effectiveness and implementation of different strategies. Copenhagen, pp 209–326 Rotter T, Baatenburg de Jong R, Lacko S E, Ronellenfitsch U, Kinsman L (2019) Chapter 12: Clinical pathways as a quality strategy. In Busse R, Klazinga N, Panteli D, Quentin W, Improving healthcare quality in Europe: characteristics, effectiveness and implementation of different strategies. Copenhagen, pp 209–326
go back to reference Rotter T, Kugler J, Koch R, Gothe, H (2006) Behandlungspfade senken Verweildauer und Kosten. Zwischenergebnisse einer weltweiten Metastudie weisen positive Effekte nach. F&W 23(6):656–659 Rotter T, Kugler J, Koch R, Gothe, H (2006) Behandlungspfade senken Verweildauer und Kosten. Zwischenergebnisse einer weltweiten Metastudie weisen positive Effekte nach. F&W 23(6):656–659
Metadata
Title
The effectiveness of clinical pathways in inpatient settings - an umbrella review
Authors
Anne Büscher
Joachim Kugler
Publication date
02-04-2024
Publisher
Springer Berlin Heidelberg
Published in
Journal of Public Health
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-024-02227-w