Evaluation of the critical pathway for oral infections

Abstract

Introduction: The critical pathway (CP) is a comprehensive systematized patient care plan for a specific procedure. At our institution, a CP for oral infection was implemented in December 2005. The aims of this study were to evaluate the CP for the procedure for this disease, and confirm the standardization of health care.
Methods: All patients after the implementation of the CP were included as subjects. For evaluation, clinical and economic parameters were used. As clinical parameters, the score according to the criteria for the evaluation of the clinical efficacy of antimicrobial drugs and the response rate were evaluated. In addition, the relationship between the dose of NSAIDs and pain scale was analyzed. As economic parameters, the mean length of hospital stay and medical cost were compared between patients before and after the CP implementation.
Results: The subjects consisted of 45 patients from the CP implementation to December 2008. During hospitalization, the drug efficacy score or the response rate did not significantly differ among groups or according to the severity of the disease. The median dose of NSAIDs was 1 tablet at day 1 and 2 tablets at days 2 and 3. The median score using the pain scale was 3 at days 1 and 2 and 2 at day 3. The rate of patient's compliance with the length of hospital stay was 82.2%. All reasons for the absence of compliance were due to the patients. The 45 patients after the CP implementation were compared with 31 patients before the PC implementation. The mean length of hospital day before the CP implementation was 7.05 ± 5.51 days, being significantly longer than that after the implementation (p = 0.022). The mean medical cost before the CP implementation was 24,109.68 ± 26,087.95 points, being significantly higher than that after the implementation (p = 0.012).
Conclusion: The results of this study confirmed the validity of the CP for oral infection at our department, and showed the possibility for new criteria for the dose of NSAIDs and pain score. The CP reduced the length of hospital stay and medical cost.