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The Effect Of Clinical Pathway Implementation On Reducing Length Of Stay, Cost and Readmission On Community-Acquired Pneumonia Hospitalized Toddlers
Corina Lisa1 Merita Arini2

1Magister Administrasi RS, Program Pascasarjana, Universitas Muhammadiyah Yogyakarta, Indonesia
1RSU Sarila Husada Sragen
2Magister Administrasi RS, Program Pascasarjana, Universitas Muhammadiyah Yogyakarta, Indonesia
2Departemen Ilmu Kedokteran Keluarga dan Ilmu Kesehatan Masyarakat, Pendidikan Dokter, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Muhammadiyah Yogyakarta, Indonesia
2Sustainable Development Goals (SDGs) Center, Universitas Muhammadiyah Yogyakarta, Indonesia
Corresponding author: drcorinalisa[at]gmail.com


Abstract

Background: Community-acquired pneumonia (CAP) in Indonesia is one of the leading causes of mortality in children under five. A clinical pathway is a multidisciplinary treatment plan built on the best clinical practices that aims to minimize care delays while maximizing care quality and clinical results. A clinical pathway is being used by hospitals to improve the efficiency of hospitalization for CAP patients.
Purpose: This study aimed to evaluate the impact of CP implementation among toddlers hospitalized with community-acquired pneumonia (CAP) on average length of stay (LOS), hospital cost, and readmission rate less than 30 days.
Methods: This cross-sectional study was conducted with subjects of pneumonia toddlers hospitalized in Sarila Husada Hospital Sragen from August 2022 to January 2023 whose clinical pathway was completed by doctors. The data were analyzed using SPSS.
Results: A total of 134 subjects were enrolled in this study, the majority were under 36 months old (111-83%), with a male preponderance (61% male to 39% female). There was a reduction in hospital costs- the cost of diagnostic investigations decreased by IDR 10.104,55 (p 0.562), the cost of medications decreased by IDR 214.025,17 (p <0.01), and the total cost decreased by IDR 448.448,87 (p <0.01). The mean length of stay decreased by 0.3 days (p 0,175), and readmissions decreased after the implementation of CP CAP, but the results were not statistically significant (p 0,57).
Conclusion: In this study, implementation of the CP could reduce hospital costs and average LOS but have no significant effect on reducing readmission rates. It needs further research on detailed cost-unit analysis to prove the effectiveness of CP implementation.

Keywords: Keywords: Community-acquired pneumonia- clinical pathway- length of stay- cost- readmission.

Topic: Management and Informatic Health Science

Plain Format | Corresponding Author (Corina Lisa)

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