Relationship between patient costs and patient pathways
Artikel i vetenskaplig tidskrift, 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.

– 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.

– 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.

– 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.

Breast cancer

Patient cost

Process mining

Patient pathway

Quality improvement


Sara Dahlin

Chalmers, Teknikens ekonomi och organisation, Service Management and Logistics

Hendry Raharjo

Chalmers, Teknikens ekonomi och organisation, Service Management and Logistics

International Journal of Health Care Quality Assurance

0952-6862 (ISSN)

Vol. 32 1 246-261

Aktionsforskning rörande utveckling mot en mer patientfokuserad cancervård

Regionalt cancercentrum Väst, 2015-07-01 -- 2020-06-30.







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