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 | 2b |
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 |