2023 Fiscal Year Final Research Report
Research on the effects and appropriate operation of clinical pathways on the quality and safety of medical care and hospital management
| Project/Area Number |
20K10322
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 58010:Medical management and medical sociology-related
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| Research Institution | Nagasaki University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
川崎 浩二 長崎大学, 病院(医学系), 准教授 (60161303)
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| Project Period (FY) |
2020-04-01 – 2024-03-31
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| Keywords | クリニカルパス / 医療の質 / 医療安全 / 経営効果 / 地域連携パス |
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| Outline of Final Research Achievements |
The effects of clinical pathways on medical quality, medical safety, and management improvement were evaluated. In terms of length of hospital stay, patients who used the pathway were 7.5 days shorter than those who did not (FY2016-FY2020). In terms of quality of medical care, the readmission rate within two weeks was lower than those who did not (FY2016-FY2018). In terms of medical safety, patients who used the pathway had a lower incident reporting rate than those who did not (FY2018-FY2020). In terms of hospital management, the average income and expenditure was 76,092 yen, higher than those who did not use the pathway, at -111,559 yen, and there were significantly more cases with a profit (FY2016-FY2020). Outpatient pathways were more effective than inpatient pathways. The above shows that the effects of the pathways are not only shortening the length of hospital stay, but also improving medical quality, medical safety, and management.
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| Free Research Field |
医療情報学
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| Academic Significance and Societal Importance of the Research Achievements |
医療を取り巻く環境の変化に加えCOVID-19の影響により、特に病院経営面でのマネジメントが困難を極めている。パスは導入当初入院日数短縮を目的とされたが、標準化医療の具体的適応が可能な手法であり医療安全面を含めた医療の質改善効果が得られる。しかしながら医療の質改善や病院経営面の効果のエビデンスは乏しい。本研究により入院日数短縮効果はもちろん、医療の質、医療安全に加え病院経営面でもパスの有効性を示した。この結果はパス利用が、入院日数短縮と医療の質を両立させつつ、経営効果を高めるという求められる命題を解決する数少ない手段を示したものであり、学術的にも社会的にも意義深いものと考える。
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