Exploring Patient’s Clinical Outcomes, Hospital Costs, and Satisfaction After the Implementation of Integrated Clinical Pathway-Based Nursing Practice Model

Abstract

Abstract Introduction: The prevalence of non-communicable diseases in Indonesia tends to increase accompanied by an increase in the National Health Insurance claim costs by 18%-25% every year leading to the Indonesian government encouraging the use of clinical pathways to achieve optimal quality of health services. Methods: The method used in this study was action research by developing, implementing, and evaluating the clinical guidelines and integrated clinical pathways (ICPs) for 10 diseases that were categorized as high volume, high risk, and high cost. Data was collected through observation and interviews and was analyzed using IBM SPSS Statistics version 28. Results:A total of 40 patients from Haji Hospital (n= 20) and from Labuang Baji Hospital (n= 20) with diagnoses of pulmonary tuberculosis, pneumonia, dyspepsia, typhoid fever, normal delivery, and COPD were included and analyzed. Compliance with the ICPs in both hospitals is quite low, 50.02% in Haji Hospital and 44.46% in Labuang Baji Hospital. However, the length of patients’ stay (LOS) was found to be compliant and some exceeded the ICP standards. The patients’ hospital costs were found to be different in earning profit for all disease diagnoses. Patient satisfaction also improved with each diagnosis. Conclusion: The implementation of ICP at both hospitals showed that all indicators of patient clinical outcomes improved according to the time specified in ICP, resulting in patients’ LOS being shorter than stipulated in ICP and an increase in patient satisfaction. ICP implementation has also led to hospitals earning different profits in almost all diagnoses.