Call Us: US - +1 845 478 5244 | UK - +44 20 7193 7850 | AUS - +61 2 8005 4826

evidence-based decision making

Towards an evidence-based decision making healthcare system management: Modelling patient pathways to improve clinical outcomesFirst, to introduce a random effects continuation-ratio logit model, suitable for detecting stage wise transitions, to patient pathways modelling. Second, we aim at advancing our knowledge with regard to the application of modelling techniques to patient pathways. We study individual clinical pathways of chronic obstructive pulmonary disease (COPD) patients, a source of concern for major stakeholders. Data on COPD patients were extracted from the national English Hospital Episodes Statistics dataset. Individual patient pathways from initial admission through to more than four readmissions are captured. We notice that as patients are frequently readmitted, males are more likely to be in the higher risk group than females. Furthermore, the number of previous readmissions has a direct impact on the propensity of experiencing a further readmission. This model is very useful in detecting the most critical threshold at which multiple readmissions are more probable. Clinicians should note that a first readmission signifies a problem in the process of care and if care is not taken this may be the beginning of many subsequent readmissions. Our method could easily be implemented as a decision support tool to determine disease specific probabilities of multiple readmissions