Clinical Pathway On Operative Breast Cancer And Its Application Value

Purpose: Exploring the value of clinical pathway in controlling medical cost by analyzing the factors affecting the medical cost of the patients with operative breast cancer.Method: At first, statistics single variable and multivariable analysis was employed to analyze the factors affecting medical cost of the patients with operative breast cancer in hospital. Then, the clinical pathway of the patients with operative breast cancer in hospital was designed by analysis of standard clinical pathway through Delphi method, which had been demonstrated. At last, the standard medical cost the patients with operative breast cancer in hospital were calculated based on standard clinical pathway, which were compared with the real medical cost.Result: The mean medical cost of operative breast cancer in hospital was RMB 10,474.93 the proportions of chemical drug cost in which was in top (45.41%).The factors affecting medical cost were ranked by multiple linear regression coefficients, including the days in hospital, the stage of cancer, chemotherapy, and postoperative complication. The designed clinical pathway was confirmed feasible by reliability test of Delphi. Comparing the real medical cost with the one that calculated from clinical pathway, the real total medical cost were significantly higher than the standard cost, and the real cost of bed, diagnosis, therapy, nursing, blood test, and chemical drug were significantly higher than the corresponding standard ones according to clinical pathway. However, the real cost of operation material were close to the standard one, and the real cost of X-ray, blood test were significantly lower than the standard. Conclusion: Carrying out the clinical pathway can help to lower medical cost and shorten average length of stay in hospital effectively, which will also challenge our existing medical service system.