Relationship between patient costs and patient pathways
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 11 February 2019
Issue publication date: 11 February 2019
Abstract
Purpose
The purpose of this paper is to identify actual (as-is) patient pathway variation among breast cancer patients and to investigate the relationship between pathways and the cost incurred by patients.
Design/methodology/approach
Both quantitative and qualitative methods were employed to analyze data from four Swedish hospital groups. Quantitative methods include event-log data mining and statistical analyses on the related patient cost from the Swedish breast cancer quality registry and case-costing system. Qualitative methods included collaboration with and interviewing domain experts.
Findings
Unique pathways, followed by only one patient, were generally costlier than the most and less frequent pathways. Earlier study findings are confirmed for mastectomy patients, with more frequent pathways having a lower cost, whereas contradicting and inconclusive results emerged for the partial mastectomy patient groups. Highest variation in pathways was identified for patients receiving chemotherapy.
Practical implications
The common belief – if one follows a standardized patient pathway, then the cost will be lower – should be re-examined based on the actual pathways that occur in reality.
Originality/value
The relationships between patient pathways and patient cost allow more complex insights, beyond the general causal relationship between successfully implementing a “to-be” care pathway and lower cost. This highlights data-driven research’s importance, where actual pathways (as-is) provide more useful information than to-be care pathways.
Keywords
Acknowledgements
The authors acknowledge the domain experts’ invaluable contribution (data expert, nurse and physicians) at the Region Västra Götaland, Per Sjöli, Roger Olofsson Bagge, Carin Wångblad, Per Nyman and Pernilla Fagerlind, to name a few; and the financial support from Regional Cancer Centre West through the Centre for Healthcare Improvement (CHI) at Chalmers University of Technology.
Citation
Dahlin, S. and Raharjo, H. (2019), "Relationship between patient costs and patient pathways", International Journal of Health Care Quality Assurance, Vol. 32 No. 1, pp. 246-261. https://doi.org/10.1108/IJHCQA-10-2017-0199
Publisher
:Emerald Publishing Limited
Copyright © 2019, Emerald Publishing Limited