Clinical Pathway Of Breast Cancer In Perioperative Period With Integrated Chinese And Western Medicine

1 ObjectiveThe aim of this study was to assess the effect of clinical pathway (CP) for breast cancer in perioperative period on the control of cost of hospitalization, length of stay and quality of care, to provide a scientific, viable evidence for diagnosing and treating breast cancer in perioperative period.2 MethodThe CP list was developed for breast cancer in perioperative period with integrated traditional Chinese and Western medicine. 167 operable patients were divided into two groups from june 2004 to june 2005.83 patients who were managed on the clinical pathway compared with 85 patients in the control (horizontal comparison) group on the traditional ways. 74 patients who admitted to this study in 2003 were used as another control (historical comparison). The length of stay,cost and quality of care were compared in the three groups by describing analysis,T-test,chi square test and so on.3 ResultThe Length of stay of CP is two days less than the horizontal comparison (P＜0.01), and equal to the historical comparison, There was no statistically difference in the day waiting for operation. Compared with historical comparison the total cost and mean cost per day of CP were significantly reduced (P＜0.01), the cost of treatment (P＜0.05),western medicine (P＜0.01) and traditional Chinese medicine(P＜0.01) decreased obviously, but Laboratory test cost was increased deeply (P＜0.01). By contrast with horizontal comparison the cost of total rarely reduced (P=0.051), the cost of treatment (P＜0.05) and chinese patent medicine (P＜0.01) reduced distinctly, but continued the cost of Western medicine and Laboratory test (P＞0.05). The cost of accommodation, examination, traditional chinese medicine and operation had no significant difference (P＞0.05) among the three groups. However the day of using antibiotic was less than others (P＜0.01). There were no statistic difference in the rate of operative complication, anesthesia complication, unexpected readmission within 15 days, unplanned transfer to ICU and satisfaction among the three groups.4 ConclusionThe implementation of CP for breast cancer in perioperative period has made cost, length of stay decreased and the quality of care continued, made the inspection and useing of drugs reasonably, should be widely applied.