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Clinical pathways in China – an evaluation

Jingwei, Alex He, Yang, Wei (2015) Clinical pathways in China – an evaluation. International Journal of Health Care Quality Assurance, 28 (4). ISSN 0952-6862. (doi:10.1108/IJHCQA-09-2014-0096) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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Abstract

Purpose Clinical pathways are multidisciplinary care plans with essential care steps for patients with specific clinical problems. Clinical pathways were introduced in China in 2009 to assure quality, reduce risks, increase resource efficiency and control costs. We present a Chinese public hospital case study where a clinical pathway pilot was undertaken where we evaluate two main outcomes: stay and hospitalization costs for a tertiary hospital from 2010 to 2012 using a mixed methods approach. Design/methodology/approach Data were drawn from hospital records and in-depth interviews with hospital staff in a Shanxi Province tertiary hospital, northern China. Findings We found that the main objectives: to standardize treatment procedures by reducing stay and containing costs, were not fully achieved. Staff implementing clinical pathways clearly encountered several barriers; i.e., managers did not see the pilot as a useful managerial instrument driven by revenue generation. Physicians, too, lacked incentive to follow the guidelines due to income concerns. Practical implications We point to the daunting challenges brought about by perverse incentives embedded in the country’s health system. We argue that concerted efforts are needed to undertake difficult health policy reforms in China. Originality/value We present the first empirical study in the English-language literature that examines China’s ongoing clinical pathway pilots from a micro perspective. We combine qualitative and quantitative methods and reveal the hospital-level dynamics in its implementation.

Item Type: Article
DOI/Identification number: 10.1108/IJHCQA-09-2014-0096
Subjects: D History General and Old World > DS Asia
R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 11 Mar 2015 15:26 UTC
Last Modified: 29 May 2019 14:20 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/47629 (The current URI for this page, for reference purposes)
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