The Impact of Clinical Pathway Implementation on Length of Stay and Hospital Cost: A Systematic Review

Herlin Putri Tanjung, Atik Nurwahyuni


Faculty of Public Health, Universitas Indonesia



Background: Clinical Pathway (CP) is a method of clinical documentation that re­flects clinical practice standards for physicians, nurses, and other members of health­care team. Clinical pathways are increasingly being used by hospitals to improve effi­cien­cy in the care of certain patient populations. This study aimed to review sys­tema­ti­cal­ly the impact of CP implementation on length of stay and hospital cost.

Subjects and Method: A systematic review was conducted by searching published articles from 2010 to 2019 from databases including: Proquest, Scopus, and Pubmed. The keywords for this review “impact, implementation, clinical pathways, critical path­ways, care pathways, integrated care pathways, hospital costs and length of stay”. The de­pendent variables were length of stay and hospital cost. The independent variable was CP. There we­re 7 articles obtained after implementing the inclusion criteria.

Results: There was a significant reduction in hospital costs and length of stay after the im­plementation of CP. There was no significant difference between before and after the ap­plication of CP in aspects of complication, mortality, readmission, and clinical out­come.

Conclusion: Implementation of CP can significantly reduce hospital length of stay and cost without reducing the quality of health service.

Keywords: clinical pathway, length of stay, hospital cost

Correspondence: Herlin Putri Tanjung. Faculty of Public Health, Universitas Indonesia, Depok, West Java. Email: Mobile: 081584203086.


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