Abstract
We examined the effect of the introduction of critical pathway in surgical ward especially focusing on the gastric cancer case. We started 14 kinds of critical pathway including gastric cancer from August 2001. We studied the economical efficiency during two years (before and after critical pathway started) with the length of stay, the number of new hospitalization and the total amount medical expense, the average medical expenses a day of 156 gastric cancer patients (74 examples before critical pathway started and 82 examples after). The standardization of medical treatment of those patients was examined from each medical examination act such as a meal start after operation, intravenous drip medication period, an antibiotic medication days, postoperative admission days and the removal of nasal tube drain. We performed the questionnaire to them to know the degree of their satisfactory. The length of stay becomes short and the number of new hospitalization increases. The total amount medical expenses become low, but the average medical expenses a day becomes high. Medical standardization progresses among each doctor. Intravenous drip medication, the antibiotic medication period are significantly shortened. Nasal tube and drain are removed earlier than before with a significant difference. As a result patient undergone an operation begin to walk early and become to leave hospital early. The complication rate is reduced, but there is no significant difference. The degree of patient satisfactory is extremely high and not only a patient but a family can participate in medical treatment positively. We can get the economical efficiency effect, medical standardization and the patient satisfactory by critical pathway introduction.
