Study of the Application of Clinical Pathways in Varicella, Acute Bacillary Dysentery, Measles, Scarlet Fever, and Rubella

Zhe Xu, MD, PhD, En-qiang Qin, MD, Min Zhao, MS, Wei-ming Nie, MS, Zhi-ping Zhou, MS, Bo Tu, MS, Wei-wei Chen, PhD, Dan Wu, BS, Fei Wang, MS, Jin Li, MS


In order to explore the clinical pathways that fit the actual situation of our country and department of infectious diseases, an analysis was performed to evaluate the effectiveness of clinical pathways for varicella, acute bacillary dysentery, measles, scarlet fever and rubella when compared with traditional standard medical care. Using a retrospective comparative study design, varicella, acute bacillary dysentery, measles, scarlet fever and rubella patients who were managed on a clinical pathway (clinical pathway group) were compared with a retrospective group of patients who received traditional medical care (control group) prior to the pathway's implementation. The following outcomes were measured: length of hospital stay, hospitalization costs. There was a significant reduction in the median hospitalization costs in the clinical pathway group patients in all five infectious diseases (P<0.05). The clinical pathway group's length of hospital stay for varicella, measles, acute bacillary dysentery and rubella were significantly shorter than the control group (P<0.05). The implementation of clinical pathways in varicella, acute bacillary dysentery, measles, scarlet fever and rubella might contribute to better quality of care and cost-effectiveness.


clinical pathway, varicella, acute bacillary dysentery, measles, scarlet fever, rubella

Full Text:



Panella M, Marchisio S, Gardini A, Di SF. A cluster randomized controlled trial of a clinical pathway for hospitaltreatment of heart failure: study design and population. BMC Health Serv Res. 2007;7:179.

El BN, Middel B, van DJP, Oosterhof A, Boonstra PW, Reijneveld SA. Are the outcomes of clinical pathways evidence-based? A critical appraisal ofclinical pathway evaluation research. J Eval Clin Pract. 2007;13(6):920-929.

De Luca A, Toni D, Lauria L, et al. An emergency clinical pathway for stroke patients--results of a clusterrandomised trial (isrctn41456865). BMC Health Serv Res. 2009;9:14.

Nakanishi M, Sawamura K, Sato S, Setoya Y, Anzai N. Development of a clinical pathway for long-term inpatients with schizophrenia. Psychiatry Clin Neurosci. 2010;64(1):99-103.

Ciaschi A, Caprara A, Gillespie F, Furnari G, Mamede S. Changing doctors' behaviours: an educational program to disseminate a newclinical pathway for the hospital management of hip fractures in elderly patientsin the Lazio Region, Italy. J Eval Clin Pract. 2011;17(4):811-818.

Jayaram A, Nagel RW, Jasty R. Impact of clinical pathway on quality of care in sickle cell patients. J Pediatr Hematol Oncol. 2010;32(7):537-539.

Ryu M, Hamano M, Nakagawara A, et al. The benchmark analysis of gastric, colorectal and rectal cancer pathways: toward establishing standardized clinical pathway in the cancer care. Jpn J Clin Oncol. 2011;41(1):2-9.

Chalkidou K, Lord J, Obeidat NA, et al. Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care. Int J Technol Assess Health Care. 2011;27(2):151-158.

Cheah J. Development and implementation of a clinical pathway programme in an acute caregeneral hospital in Singapore. Int J Qual Health Care. 2000;12(5):403-412.

Barbieri A, Vanhaecht K, Van Herck P, et al. Effects of clinical pathways in the joint replacement: a meta-analysis. BMC Med. 2009;7:32.

Brown MD, Reeves MJ, Glynn T, Majid A, Kothari RU. Implementation of an emergency department based transient ischemic attack clinical pathway: a pilot study in knowledge translation. Acad Emerg Med. 2007;14(11):1114-1119.

Lee TY, Chan T, Chang CS, Lan JL. Introducing a clinical pathway for acute peptic ulcer bleeding in general internal medicine wards. Scand J Gastroenterol. 2008; 43(10):1169-1176.

Verdu A, Maestre A, Lopez P, Gil V, Martin-Hidalgo A, Castano JA. Clinical pathways as a healthcare tool: design, implementation and assessment of a clinical pathway for lower-extremity deep venous thrombosis. Qual Saf Health Care. 2009;18(4):314-320.

Coetzer R. A clinical pathway including psychotherapy approaches for managing emotional difficulties after acquired brain injury. CNS Spectr. 2009;14(11):632-638.

de Klundert J v, Gorissen P, Zeemering S. Measuring clinical pathway adherence. J Biomed Inform. 2010;43(6):861-872.

Frei CR, Bell AM, Traugott KA, et al. A clinical pathway for community-acquired pneumonia: an observational cohortstudy. BMC Infect Dis. 2011;11:188.

Huang Z, Lu X, Duan H. On mining clinical pathway patterns from medical behaviors. Artif Intell Med. 2012;56(1):35-50.

Aoki T, Nakajima T, Saito Y, et al. Assessment of the validity of the clinical pathway for colon endoscopicsubmucosal dissection. World J Gastroenterol. 2012;18(28):3721-3726.

Hauck LD, Adler LM, Mulla ZD. Clinical pathway care improves outcomes among patients hospitalized for community-acquired pneumonia. Ann Epidemiol. 2004;14(9):669-675.

Frei CR, Bell AM, Traugott KA, et al. A clinical pathway for community-acquired pneumonia: an observational cohortstudy. BMC Infect Dis. 2011;11:188.

Frutos MD, Lujan J, Hernandez Q, Valero G, Parrilla P. Clinical pathway for laparoscopic gastric bypass. Obes Surg. 2007;17(12):1584-1587.

Mazzini MJ, Stevens GR, Whalen D, Ozonoff A, Balady GJ. Effect of an American Heart Association Get With the Guidelines program-basedclinical pathway on referral and enrollment into cardiac rehabilitation afteracute myocardial infarction. Am J Cardiol. 2008; 101(8):1084-1087.

Morrison CA, Lee TC, Wall MJ Jr, Carrick MM. Use of a trauma service clinical pathway to improve patient outcomes for retainedtraumatic hemothorax. World J Surg. 2009;33(9):1851-1856.

Lau TW, Leung F, Siu D, Wong G, Luk KD. Geriatric hip fracture clinical pathway: the Hong Kong experience. Osteoporos Int. 2010;21(Suppl 4):S627-S636.

Beriwal S, Rajagopalan MS, Flickinger JC, Rakfal SM, Rodgers E, Heron DE. How effective are clinical pathways with and without online peer-review? Ananalysis of bone metastases pathway in a large, integrated National CancerInstitute-Designated Comprehensive Cancer Center Network. Int J Radiat Oncol Biol Phys. 2012;83(4):1246-1251.


  • There are currently no refbacks.