Clinical pathways for three rheumatological indications have been successfully developed in the rheumatological departments of two hospitals. These diseases were selected because of the number of inpatients seen and/or the costs for diagnostics and therapy. Three quota-concepts, the coordination of treatment processes (quota-concept I), the sequence of implementing services (quota-concept II), and the economical utilization of available resources as well as the transparent definition of therapies (quota-concept III) have been established. These concepts have been tested individually as well as in complex situations.
Clinical pathways constitute a useful tool for structuring diagnostic and therapeutic measures during the period of inpatient treatment. They primarily serve to ensure and improve quality and only secondarily to reduce costs. International experience in evaluating clinical pathways confirms these statements. The introduction of clinical pathways across disciplines and professional groups succeeds when the treatment team can be motivated to accept this concept. Only when this is achieved will it be possible for clinical pathways to lead to improved results for the patient as well as the hospital while simultaneously reducing costs and length of hospital stay.
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