The Effect of Applying Clinical Pathways on Medical Resource Utilization among Patients Undergoing a Thyroidectomy

Pan, L. F., Lin, W. D., Tang, P. L., Yan, W. R., Lin, C., and Hsu, S. 2023. The Effect of Applying Clinical Pathways on Medical Resource Utilization among Patients Undergoing a Thyroidectomy. NTU Management Review, 33 (1): 163-190. https://doi.org/10.6226/NTUMR.202304_33(1).0005

Li-Fei Pan, Department of General Affairs Administration, Kaohsiung Veterans General Hospital
Wen-Der Lin, Department of Health Care Administration, Chang Jung Christian University
Pei-Ling Tang, Research Center of Medical Informatics, Kaohsiung Veterans General Hospital/Department of Nursing, Fooyin University
Wun-Rong Yan, Department of Medical Affair Administration, Kaohsiung Veterans General Hospital
Chaohsin Lin, Department of Risk Management and Insurance, National Kaohsiung University of Science and Technology
Shuofen Hsu, Department of Risk Management and Insurance, National Kaohsiung University of Science and Technology

Abstract

Taiwan' s National Health Insurance Administration (NHIA) began large-scale implementing the case payment method from 1997 with a view to reducing inpatient costs. Hospitals have adopted several management control systems such as Clinical Pathways (CPs) in response to the challenges of maintaining both fiscal soundness and the quality of medical care. The objective of this study is to assess the effects of CPs on the utilization of medical resources, particularly on the practice of thyroidectomy. We evaluate a total of 376 case payments for thyroidectomies operating in an academic medical center from 2001 to 2003 and compare differences between pre- and post-CPs implementation in terms of medical costs and Length of Stay (LOS). The empirical results show that after the implementation of the CPs, the reductions in LOS (31.90%) and in medical expenditure (14.98%) within the General Surgery (GS) department are statistically significant. In addition, the medical resource utilization in the GS division with CPs is significantly lower than that in the Ear, Nose, and Throat (ENT) division without implementing such a program. This study demonstrates that the CPs reduce hospital costs and improve the standard of medical care for patients. Further research is warranted to investigate the cost-effectiveness of CPs implementation and the potential risk of cost shifting from the inpatient to outpatient departments.  


Keywords

case paymentClinical Pathways (CPs)thyroidectomyLength of Stay (LOS)medical expenses


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