Lifland Brooke, Wright Davene R, Mangione-Smith Rita, Desai Arti D
University of Washington School of Medicine, Seattle, WA, USA.
Seattle Children's Research Institute, 2001 Eighth Avenue, Suite 400, Seattle, WA, 98121, USA.
Adm Policy Ment Health. 2018 Nov;45(6):979-987. doi: 10.1007/s10488-018-0878-6.
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions. Understanding which care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
临床路径已知可提高医疗和外科环境中医疗保健的价值，但在精神科环境中很少被研究。本研究调查了青少年抑郁症住院患者临床路径的依从程度与住院时间（LOS）、费用和再入院之间的关联。与低依从类别相比，高依从类别的患者住院时间显著更长，费用更高。30天急诊复诊或再入院的几率没有差异。了解路径中的哪些护理流程对于改善以患者为中心的结果最具成本效益需要进一步调查。
