Review of methods and study designs of evaluations related to clinical pathways

Lee, Xing Ju, Blythe, Robin, Choudhury, Adnan Ali Khan, Simmons, Toni, Graves, Nicholas, and Kularatna, Sanjeewa (2019) Review of methods and study designs of evaluations related to clinical pathways. Australian Health Review, 43 (4). pp. 448-456.

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Objective: The HealthPathways program is an online information portal that helps clinicians provide consistent and integrated patient care within a local health system through localised pathways for diagnosis, treatment and management of various health conditions. These pathways are consistent with the definition of clinical pathways. Evaluations of HealthPathways programs have thus far focused primarily on website utilisation and clinical users' experience and satisfaction, with limited evidence on changes to patient outcomes. This lack motivated a literature review of the effects of clinical pathways on patient and economic outcomes to inform a subsequent HealthPathways evaluation.

Methods: A systematic review was performed to summarise the analytical methods, study designs and results of studies evaluating clinical pathways with an economic outcome component published between 1 January 2000 and 31 August 2017 in four academic literature databases.

Results: Fifty-five relevant articles were identified for inclusion in this review. The practical pre-post study design with retrospective baseline data extraction and prospective intervention data collection was most commonly used in the evaluations identified. Straightforward statistical methods for comparing outcomes, such as the t-test or chi(2) test, were frequently used. Only four of the 55 articles performed a cost-effectiveness analysis. Clinical pathways were generally associated with improved patient outcomes and positive economic outcomes in hospital settings.

Conclusions: Clinical pathways evaluations commonly use pragmatic study designs, straightforward statistical tests and cost-consequence analyses. More HealthPathways program evaluations focused on patient and economic outcomes, clinical pathway evaluations in a primary care setting and cost-effectiveness analyses of clinical pathways are needed.

Item ID: 60125
Item Type: Article (Research - C1)
ISSN: 1449-8944
Keywords: health services research, performance and evaluation
Copyright Information: (C) AHHA 2019
Funders: Northern Queensland Primary Health Network
Date Deposited: 28 Aug 2019 07:49
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems @ 100%
Downloads: Total: 1
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