Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes:
- PDF / 741,106 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 50 Downloads / 164 Views
RESEARCH
Open Access
Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis Jolanda C. van Hoeve1,2*, Robin W. M. Vernooij3,4, Michelle Fiander5, Peter Nieboer6, Sabine Siesling1,2 and Thomas Rotter7
Abstract Background: Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and metaanalysis aiming to identify and synthesize existing literature on the effects of pathways in oncological care. Methods: All patients diagnosed with cancer in primary and secondary/tertiary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding patients, professionals, and system level were extracted from each study. Results: Out of 13,847 search results, we selected 158 articles eligible for full text assessment. One hundred fifty studies were excluded and the remaining eight studies represented 4786 patients. Most studies were conducted in secondary/tertiary care. Length of stay (LOS) was the most common used indicator, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (weighted mean difference (WMD)): − 2.75, CI: − 4.67 to − 0.83) and gynecological cancer (WMD: − 1.58, CI: − 2.10 to − 1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions: Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary/tertiary care regarding the positive effects of LOS in favor of cancer care pathways. Systematic review registration: PROSPERO CRD42017057592. Keywords: Care pathways, Clinical pathways, Integrated care pathways, Care maps, Oncology, Cancer, Systematic review
* Correspondence: [email protected] 1 Department Health Technology & Services Research, University of Twente, Enschede, the Netherlands 2 Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not
Data Loading...
