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The Effect of Applying Clinical Pathways on Medical Resource Utilization among Patients Undergoing a Thyroidectomy
Ist Teil von
臺大管理論叢, 2023-04, Vol.33 (1)
Ort / Verlag
國立臺灣大學管理學院
Erscheinungsjahr
2023
Quelle
BSC - Ebsco (Business Source Ultimate)
Beschreibungen/Notizen
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.