Relationship between patient costs and patient pathways

Journal article, 2019

Purpose – The purpose of this paper is to identify actual (as-is) patient pathway variation among breast
cancer patients and to investigate the relationship between pathways and the cost incurred by patients.

Design/methodology/approach – Both quantitative and qualitative methods were employed to analyze
data from four Swedish hospital groups. Quantitative methods include event-log data mining and statistical
analyses on the related patient cost from the Swedish breast cancer quality registry and case-costing system.
Qualitative methods included collaboration with and interviewing domain experts.

Findings – Unique pathways, followed by only one patient, were generally costlier than the most and less
frequent pathways. Earlier study findings are confirmed for mastectomy patients, withmore frequent pathways
having a lower cost, whereas contradicting and inconclusive results emerged for the partial mastectomy patient
groups. Highest variation in pathways was identified for patients receiving chemotherapy.

Practical implications – The common belief – if one follows a standardized patient pathway, then the cost
will be lower – should be re-examined based on the actual pathways that occur in reality.

Originality/value – The relationships between patient pathways and patient cost allow more complex
insights, beyond the general causal relationship between successfully implementing a “to-be” care pathway
and lower cost. This highlights data-driven research’s importance, where actual pathways (as-is) provide
more useful information than to-be care pathways.