IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i11p5918-d566417.html
   My bibliography  Save this article

Effects of Clinical Pathways on Cesarean Sections in China: Length of Stay and Direct Hospitalization Cost Based on Meta-Analysis of Randomized Controlled Trials and Controlled Clinical Trials

Author

Listed:
  • Dan Lin

    (Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai 200032, China)

  • Chunyang Zhang

    (Fujian Center for Disease Control and Prevention, Fuzhou 350001, China)

  • Huijing Shi

    (Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai 200032, China)

Abstract

The cesarean section (CS) on maternal request increased sharply in China, bringing pressure to medical resources and national insurance. We assessed the use of clinical pathways (CPWs) for CS compared with conventional medical care by outcomes of length of stay (LOS) in hospital and direct hospitalization cost (DHC). Four Chinese electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang, CQVIP, and SinoMed, were explored to December 2020 for the full-text papers published in Chinese. Literature that quantitatively assessed the effects of CPW on LOS or DHC were eligible for inclusion. The weighted mean differences (WMDs) were pooled. Twenty-five articles were included in our analysis, with a total sample of 7761 women. These studies were performed from 2004 to 2017 and reported from 2005 to 2018. The synthesized results showed a shorter LOS (in days) (WMD = −1.37, 95% CI: −1.48 to −1.26) and a less DHC (CNY¥) (WMD = −520.46, 95% CI: −554.06 to −503.63) in the CPW group, comparing with that of conventional care. With the need for CS on the rise, the introduction of CPW could effectively reduce LOS and DHC, thereby releasing the medical resources and insurance pressure.

Suggested Citation

  • Dan Lin & Chunyang Zhang & Huijing Shi, 2021. "Effects of Clinical Pathways on Cesarean Sections in China: Length of Stay and Direct Hospitalization Cost Based on Meta-Analysis of Randomized Controlled Trials and Controlled Clinical Trials," IJERPH, MDPI, vol. 18(11), pages 1-15, May.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5918-:d:566417
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/11/5918/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/11/5918/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Cai, W.-W. & Marks, J.S. & Chen, C.H.C. & Zhuang, Y.-X. & Morris, L. & Harris, J.R., 1998. "Increased cesarean section rates and emerging patterns of health insurance in Shanghai, China," American Journal of Public Health, American Public Health Association, vol. 88(5), pages 777-780.
    2. Tom M. Palmer & Jaime L. Peters & Alex J. Sutton & Santiago G. Moreno, 2008. "Contour-enhanced funnel plots for meta-analysis," Stata Journal, StataCorp LP, vol. 8(2), pages 242-254, June.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Shaylea Badovinac & Jodi Martin & Camille Guérin-Marion & Monica O’Neill & Rebecca Pillai Riddell & Jean-François Bureau & Rebecca Spiegel, 2018. "Associations between mother-preschooler attachment and maternal depression symptoms: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-27, October.
    2. Chun-Yu Chang & Po-Chen Lin & Yung-Jiun Chien & Chien-Sheng Chen & Meng-Yu Wu, 2020. "Analysis of Chest-Compression Depth and Full Recoil in Two Infant Chest-Compression Techniques Performed by a Single Rescuer: Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 17(11), pages 1-17, June.
    3. Aliasghar Ahmad Kiadaliri & Johan Jarl & Georgios Gavriilidis & Ulf-G Gerdtham, 2013. "Alcohol Drinking Cessation and the Risk of Laryngeal and Pharyngeal Cancers: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-10, March.
    4. Ivan Ropovik & Matus Adamkovic & David Greger, 2021. "Neglect of publication bias compromises meta-analyses of educational research," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-14, June.
    5. Junna Wang & Dandan Zhang & Rongzhong Huang & Xingsheng Li & Wenxiang Huang, 2017. "Gamma-glutamyltransferase and risk of cardiovascular mortality: A dose-response meta-analysis of prospective cohort studies," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-19, February.
    6. Monica L Joustra & Isidor Minovic & Karin A M Janssens & Stephan J L Bakker & Judith G M Rosmalen, 2017. "Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-25, April.
    7. İlkay Unay-Gailhard & Mark A. Brennen, 2022. "How digital communications contribute to shaping the career paths of youth: a review study focused on farming as a career option," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 39(4), pages 1491-1508, December.
    8. Mahin Ghafari & Vali Baigi & Zahra Cheraghi & Amin Doosti-Irani, 2016. "The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-10, June.
    9. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    10. Santos Urbina & Sofía Villatoro & Jesús Salinas, 2021. "Self-Regulated Learning and Technology-Enhanced Learning Environments in Higher Education: A Scoping Review," Sustainability, MDPI, vol. 13(13), pages 1-12, June.
    11. Oded Berger-Tal & Alison L Greggor & Biljana Macura & Carrie Ann Adams & Arden Blumenthal & Amos Bouskila & Ulrika Candolin & Carolina Doran & Esteban Fernández-Juricic & Kiyoko M Gotanda & Catherine , 2019. "Systematic reviews and maps as tools for applying behavioral ecology to management and policy," Behavioral Ecology, International Society for Behavioral Ecology, vol. 30(1), pages 1-8.
    12. Nadine Desrochers & Adèle Paul‐Hus & Jen Pecoskie, 2017. "Five decades of gratitude: A meta‐synthesis of acknowledgments research," Journal of the Association for Information Science & Technology, Association for Information Science & Technology, vol. 68(12), pages 2821-2833, December.
    13. Maryono, Maryono & Killoes, Aditya Marendra & Adhikari, Rajendra & Abdul Aziz, Ammar, 2024. "Agriculture development through multi-stakeholder partnerships in developing countries: A systematic literature review," Agricultural Systems, Elsevier, vol. 213(C).
    14. Alene Sze Jing Yong & Yi Heng Lim & Mark Wing Loong Cheong & Ednin Hamzah & Siew Li Teoh, 2022. "Willingness-to-pay for cancer treatment and outcome: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1037-1057, August.
    15. Xue-Ying Xu & Hong Kong & Rui-Xiang Song & Yu-Han Zhai & Xiao-Fei Wu & Wen-Si Ai & Hong-Bo Liu, 2014. "The Effectiveness of Noninvasive Biomarkers to Predict Hepatitis B-Related Significant Fibrosis and Cirrhosis: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-16, June.
    16. Vicente Miñana-Signes & Manuel Monfort-Pañego & Javier Valiente, 2021. "Teaching Back Health in the School Setting: A Systematic Review of Randomized Controlled Trials," IJERPH, MDPI, vol. 18(3), pages 1-18, January.
    17. Michael J. Crowther & Dean Langan & Alex J. Sutton, 2012. "Graphical augmentations to the funnel plot to assess the impact of a new study on an existing meta-analysis," Stata Journal, StataCorp LP, vol. 12(4), pages 605-622, December.
    18. Agnieszka A. Tubis & Katarzyna Grzybowska, 2022. "In Search of Industry 4.0 and Logistics 4.0 in Small-Medium Enterprises—A State of the Art Review," Energies, MDPI, vol. 15(22), pages 1-26, November.
    19. Obsa Urgessa Ayana & Jima Degaga, 2022. "Effects of rural electrification on household welfare: a meta-regression analysis," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 69(2), pages 209-261, June.
    20. Caloffi, Annalisa & Colovic, Ana & Rizzoli, Valentina & Rossi, Federica, 2023. "Innovation intermediaries' types and functions: A computational analysis of the literature," Technological Forecasting and Social Change, Elsevier, vol. 189(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5918-:d:566417. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.