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Table 2 Intervention studies (Change in cost due to change in actual guidelines)

From: Do clinical guidelines reduce clinician dependent costs?

Reference/Design Country/setting Inclusion criteria/intervention Degree of financial saving LOE
Newton and Young (2006); Before and after study[16] USA Inpatient diabetes management programme Reduction in length of stay for patients with diabetes.
Has resulted in savings of more than $2 million for the year and has yielded a 467% return on investment
McMullin et-al. (2005); Intervention and control[23] USA Use of commercially available electronic prescribing system with integrated clinical decision support and evidence based message capability The proportion of prescriptions for high cost drugs that were the target of this intervention to prescribers was a relative 17.5% lower among the intervention group compared with the control group 2b
Wong et-at. (2000); Intervention and control[22] Hamilton Ontario Multidisciplinary clinical pathway for oxygen management Total health system costs increased by 116% 2a
Hanna et-al. (1999); Before and after study. Before data was retrospective[18] USA Use of a clinical pathway for patients undergoing total laryngectomy The average hospital variable cost decreased from £3992 to £3419 per case. This represents a 14.4 reduction in costs associated with pathway implementation 2b
Roth et-al (2001); Before and after study[20] USA Educational intervention to decrease use of selected expensive medications Annual saving of £66000 representing 32% decrease in use of more costly anti- coagulant and a 20% increase in the use of the less costly anticoagulant 2b
Watson et-al. (2001); Cluster randomized trial[26] Avon England Evaluate the effectiveness of guidelines with or without one to one educational outreach visits by community pharmacists Mean costs reduced by 6% in practices that received mailed guidelines and educational outreach 1b
  1. LOE: Oxford centre for Evidence-Based Medicine level of evidence (May 2001)[10]