ArticleBMJ open2019
Relationship between physician financial incentives and clinical pathway compliance: a cross-sectional study of 18 public hospitals in China.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Surgeon Alignment With Clinical Practice Guidelines: A Qualitative Analysis of Treatment of Distal Radius Fractures.Hand (New York, N.Y.) · 2026Article
- Development of data-driven clinical pathways: the big data clinical evidence-based pathways.BMJ health & care informatics · 2025Article
- Satisfaction with clinical pathway implementation versus job performance of clinicians: empirical evidence on the mediating role of work engagement from public hospitals in Sichuan, China.BMC health services research · 2024Article
- Experiences of using clinical pathways in hospitals: Perspectives of quality improvement personnel.Nursing open · 2023Article
- Improving WHO's understanding of WHO guideline uptake and use in Member States: a scoping review.Health research policy and systems · 2022Article
- Data-driven integrated care pathways: Standardization of delivering patient-centered care.Frontiers in medicine · 2022Article
- 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.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMany strategies have been either used or recommended to promote physician compliance with clinical practice guidelines and clinical pathways (CPs). This study examines the relationship between hospitals' use of financial incentives to encourage physician compliance with CPs and physician adherence to CPs.
designA retrospectively cross-sectional study of the relationship between the extent to which patient care was consistent with CPs and hospital's use of financial incentives to influence CP compliance.
settingEighteen public hospitals in three provinces in China.
participantsStratified sample of 2521 patients discharged between 3 January 2013 and 31 December 2014. PRIMARY OUTCOME MEASURES: The proportion of key performance indicators (KPIs) met for patients with (1) community-acquired pneumonia (pneumonia), (2) acute myocardial infarction (AMI), (3) acute left ventricular failure (heart failure), (4) planned caesarean section (C-section) and (5) gallstones associated with acute cholecystitis and associated cholecystectomy (cholecystectomy).
resultsThe average implementation rate of CPs for five conditions (pneumonia, AMI, heart failure, C-section and cholecystectomy) based on 2521 cases in 18 surveyed hospitals was 57% (ranging from 44% to 67%), and the overall average compliance rate for the KPIs for the five conditions was 69.48% (ranging from 65.07% to 77.36%). Implementation of CPs was associated with greater compliance within hospitals only when hospitals adopted financial incentives directed at physicians to promote compliance.
conclusionCPs are viewed as important strategies to improve medical care in China, but they have not been widely implemented or adhered to in Chinese public hospitals. In addition to supportive resources, education/training and better administration in general, hospitals should provide financial incentives to encourage physicians to adhere to CPs.
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