Cancer care pathways in secondary/tertiary care demonstrate a positive effect on length of stay (LOS), according to a study in Systematic Reviews (2020;9[1]:246. doi:10.1186/s13643-020-01498-0).
“The aim of this systematic review is to assess the effects of oncological pathways according to an unambiguous definition of cancer care pathway in studies providing a high level of evidence,” wrote the study authors.
A systematic literature search in seven databases for randomized controlled trials (RCT), non-randomized studies (NRS), controlled before-after studies (CBA), and interrupted time series studies (ITS), as well as economic evaluations (cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, cost analysis, and comparative resource utilization studies), where available was performed. The study participants included patients diagnosed with cancer in primary and secondary/tertiary care. Two independent reviewers screened the studies and study outcomes were extracted.
The literature search generated 13,847 results. Of these, 158 articles had full texts available and from these, 8 met the inclusion criteria. Most studies were conducted in secondary/tertiary care and LOS was the most common used indicator. Based on subgroups, meta-analysis showed a shorter LOS with gastric and gynecological cancer. Most studies reported lower costs for pathway groups.
“Despite of the differences between the included studies, we were able to present an evidence base for cancer care pathways regarding the subgroup effects of LOS,” concluded the study authors. “However, the effects on complications, readmissions, and costs as well as the implications of differences in implementation of cancer care pathways were not conclusive enough.”—Lisa Kuhns
