The Impact of Chronic Obstructive Lung Clinical Pathway Implementation on Readmission: A Systematic Review

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the 4th leading cause of death in the world. The COPD prevalence in Indonesia was 3.7% affecting around 9.2 million population, with East Nusa Tenggara Province ranked first. COPD is expected to increase in the coming years due to the increasing of smoker and elderly population. Although it cannot be cured, the general practice of COPD aims to reduce symptom, prevent exacerbation of repetition, improve lung function, and improve the quality of life. Clinical pathway is a clinical management in a multidisciplinary hospital to increasing clinical outcomes and reducing cost by reduce the variations in services. This study aimed to systematically review the impact of COPD clinical pathway implementation on readmission. Subjects and Method: A systematic review was conducted through electronic databases, including PubMed and Scopus. The keywords used were "COPD" AND "clinical pathway" AND "readmission". The articles were collected between 2010 and 2019. The data were analyzed by PRISMA flow diagram. Results: The implementation of clinical pathway in hospital on the management of COPD showed various outcomes. Four of 6 study showed that the implementation of clinical pathways was associated with decreased readmission rate of 30 days to 90 days and mortality rate. Two other studies did not show significant decrease in readmission and mortality rates. Conclusion: The implementation of clinical pathway for COPD is associated with decreased readmission.