Causation between Pathway Completion and Reduced Hospital Stay in Patients with Lung Cancer: a Retrospective Cohort Study Using Propensity Score Matching.

We have previously demonstrated that clinical pathway completion helps reduce hospital stays. However, our previous results showed only a correlation, not causation. Therefore, the current study's aim was to analyze the causation between clinical pathway completion and reduced hospital stays for pat...

Full description

Bibliographic Details
Published in:Journal of Medical Systems Vol. 44; no. 6; pp. 1 - 10
Main Authors: Furuhata, Hiroki, Araki, Kenji, Ogawa, Taisuke
Format: research tables/charts Journal Article
Published: Springer Nature Jun2020
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143571477&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 143571477
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        01485598
        4N0
      jtl: Journal of Medical Systems
      issn: 01485598
      maglogo: N
    pubinfo:
      dt: Jun2020
      vid: 44
      iid: 6
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        143571477
        143571477
        143571477
        10.1007/s10916-020-01570-1
        143571477
      ppf: 1
      ppct: 9
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Causation between Pathway Completion and Reduced Hospital Stay in Patients with Lung Cancer: a Retrospective Cohort Study Using Propensity Score Matching.
      aug:
        au:
          Furuhata, Hiroki
          Araki, Kenji
          Ogawa, Taisuke
        affil: Department of Hospital Institutional Research, University of Miyazaki Hospital, 5200 Kibara Kiyotake-cho, 8891692, Miyazaki, Japan
      sug:
        subj:
          Critical Path
          Length of Stay
          Electronic Health Records
          Lung Neoplasms
          Quality Improvement
          Human
          Cancer Patients
          Retrospective Design
          Record Review
          Log-Rank Test
          Academic Medical Centers
          Descriptive Statistics
          T-Tests
          Kaplan-Meier Estimator
          Chi Square Test
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Data Analysis Software
          Infant, Newborn
          Infant
          Child, Preschool
          Child
          Adolescence
          Adult
          Systems Implementation
          Patient Discharge
          Patient Safety
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: We have previously demonstrated that clinical pathway completion helps reduce hospital stays. However, our previous results showed only a correlation, not causation. Therefore, the current study's aim was to analyze the causation between clinical pathway completion and reduced hospital stays for patients with lung cancer. Data were collected from April 2013 to March 2018 from the electronic medical records of the University of Miyazaki Hospital. We used propensity score matching to extract records from 227 patients. Patients were further divided into a pathway completed group and a pathway not completed group; 74 patients in each group were available for data analysis. Our main analysis involved estimating the discharge curve, which was comprised of the in-hospital rate and hospital stay. Additional analyzes were performed to compare the frequency of medical treatments registered in the clinical pathway but not implemented (termed deviated medical treatments). The occurrence of these treatments meant that the clinical pathway was not completed. The main results indicated a decrease in the in-hospital rate of the completion group, compared with the not completed group. The p value of the log-rank test was <0.001 for total patients and patients who underwent resection, and 0.017 for patients who did not undergo resection. Additional results indicated that a number of intravenous drips were not implemented, despite their registration on clinical pathways. Our results indicate that clinical pathway completion contributes to improved efficiency and safety. This simplified procedure is expected to be applicable to other diseases and clinical indicators.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N