THE IMPACT OF A CLINICAL PATHWAY FOR TRANSURETHRAL RESECTION OF THE PROSTATE ON COSTS AND CLINICAL OUTCOMES

The purpose of this study was to evaluate the effects of implementing a clinical pathway for transurethral resection of the prostate on hosp ital costs and procedures, outcomes, and complications. Consecutive pa tients who underwent transurethral resection of the prostate for benig n prostate hyperplasia in our hospital before (February-August 1996) a nd after (October 1996-March 1997) implementation of the clinical path way were included. Statistical analyses included Student's t-test to t est the impact of the clinical pathway on resource consumption and med ical care processes, and multiple linear regression to control for pat ient characteristics such as age, severity of disease, and comorbidity . The major findings of this study were that implementation of the cli nical pathway 1) decreased resource consumption and controlled medical care expenditure; 2) influenced physicians' patterns of practice and decreased the number of procedures performed; and 3) did not affect cl inical outcomes or complication rates. In conclusion, our results supp ort the hypothesis that the clinical pathway is an effective medical m anagement tool to contain costs, which does not adversely affect quali ty of care. We suggest health policy makers promote clinical pathways in more hospitals to encourage appropriate resource consumption.