The Impact of Clinical Pathway Implementation on Cost Effectiveness in Health Care Service: A Bibliometric Analysis
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Clinical pathways play a strategic role in mitigating fraud risk by reducing unnecessary variability in clinical practice. Implementing clinical pathways in hospital healthcare services has a positive impact on cost-effectiveness. To determine research trends related to the impact of clinical pathway implementation on cost-effectiveness in healthcare systems worldwide. This study used a bibliometric analysis approach. Data analysis techniques employed VOSviewer. VOSviewer tools were used for network, overlay, and density visualization. The bibliometric analysis in this study was conducted using VOSviewer software, employing a co-authorship analysis approach at the author level. This analysis identified 80 authors, with 18 authors showing the largest number of links. Implementing clinical pathways is an effective strategy for improving cost efficiency and the quality of healthcare services in hospitals. Clinical pathways need to be developed and implemented consistently to enhance cost-effectiveness, service quality, and the efficiency of the healthcare system, particularly in developing countries.
Barbosa, P. M., Szrek, H., Ferreira, L. N., Cruz, V. T., & Firmino-Machado, J. (2024). Stroke rehabilitation pathways during the first year: A cost-effectiveness analysis from a cohort of 460 individuals. Annals of Physical and Rehabilitation Medicine, 67(4). https://doi.org/10.1016/j.rehab.2024.101824
Buja, A., et al. (2016). Prevalence of heart failure and adherence to process indicators: Which socio-demographic determinants are involved? International Journal of Environmental Research and Public Health, 13(2), 238.
Cole, S., Noble, S., Gooberman-Hill, R., & Pinedo-Villanueva, R. (2024). Modelled cost-effectiveness analysis of the Support and Treatment After Replacement (STAR) care pathway for chronic pain after total knee replacement compared with usual care. Cost Effectiveness and Resource Allocation, 22(1). https://doi.org/10.1186/s12962-024-00532-5
Corrao, G., Rea, F., Iommi, M., Lallo, A., Fantaci, G., Di Martino, M., & Maggioni, A. P. (2024). Cost-effectiveness of outpatient adherence to recommendations for monitoring of patients hospitalized for heart failure. ESC Heart Failure, 11(5), 2719–2729. https://doi.org/10.1002/ehf2.14779
Fan, Y., Yang, Q., Chen, C., Hu, X., Xu, M., Weng, Y., & Liu, F. (2025). Path analysis of factors influencing length of stay and hospitalisation expenses for oral cancer patients in tertiary hospitals in southeastern China: A cross-sectional study. BMJ Open, 15(1). https://doi.org/10.1136/bmjopen-2024-087060
Galea, J. (2025). Emergency department to discharge pathways for oncology patients undergoing cancer treatment: A clinical audit.
Gustafsson, U. O., et al. (2019). Guidelines for perioperative care in elective colorectal surgery: Enhanced recovery after surgery (ERAS®) society recommendations: 2018. World Journal of Surgery, 43(3), 659–695.
Jaya, A., Sunarto, S., Sukmawan, R., Abdul Rachman, I., Muhadi, M., Wigati, R., & Noegraharti, N. (2025). Buku pedoman tata kelola pelayanan medik (A. Hernasari & A. Ramadhani, Eds., Jilid 3). Kementerian Kesehatan RI.
McLawhorn, A. S., & Buller, L. T. (2017). Bundled payments in total joint replacement: Keeping our care affordable and high in quality. Current Reviews in Musculoskeletal Medicine, 10(3), 370–377.
Miranda, R., Silverio, R., Baptista, F. M., & Oliveira, M. D. (2024). Unlocking continuous improvement in heart failure remote monitoring: A participatory approach to unveil value dimensions and performance indicators. Telemedicine and e-Health, 30(7), e1990–e2003.
Moore, A. J., et al. (2023). Healthcare professionals’ views on implementing the STAR care pathway for people with chronic pain after total knee replacement: A qualitative study. PLoS One, 18(4), e0284406.
Muhammad, H. Y. (2022). Eksplorasi faktor-faktor penyebab terjadinya high volume, high risk, dan high cost pada lima penyakit dan pengembangan format integrated clinical pathway di RSUD Kabupaten Banggai.
Rachmawaty, R., Wahyudin, E., & Bukhari, A. (2025). Exploring patient’s clinical outcomes, hospital costs, and satisfaction after the implementation of integrated clinical pathway-based nursing practice model. Cost Effectiveness and Resource Allocation, 23(1). https://doi.org/10.1186/s12962-025-00645-5
Sabe, S. A., Sabe, M. A., Kennedy, K. F., Sellke, F. W., & Ehsan, A. (2023). Risk factors for heart failure readmission after cardiac surgery. JACC: Advances, 2(8), 100599.
Septiana, S., Soekiswati, S., & Ichsan, B. (2025). Clinical pathway sebagai solusi keberlanjutan JKN di Indonesia: Systematic review. Jurnal Ekonomi Kesehatan Indonesia, 10(2). https://doi.org/10.7454/eki.v10i2.1162
Shanbhag, D., et al. (2018). Effectiveness of implementation interventions in improving physician adherence to guideline recommendations in heart failure: A systematic review. BMJ Open, 8(3), e017765.
Wylde, V., et al. (2018). Development of a complex intervention for people with chronic pain after knee replacement: The STAR care pathway. Trials, 19(1), 61.
Wylde, V., et al. (2022). The STAR care pathway for patients with pain at 3 months after total knee replacement: A multicentre, pragmatic, randomised, controlled trial. The Lancet Rheumatology, 4(3), e188–e197.
Yabroff, K. R., et al. (2019). Minimizing the burden of cancer in the United States: Goals for a high-performing health care system. CA: A Cancer Journal for Clinicians, 69(3), 166–183.
Yingtan, M., Zuo, Y., & Hu, Q. (2025). Why will increasing medical insurance reimbursement levels not lead to over-medicalization? Evidence from China’s medical insurance payment reform. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-025-00689-7
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