Clinical practice guidelines and organizational adaptation: A framework for analyzing economic effects

Objectives: The overall objective of this article was to review the theoretical and conceptual dimensions of how the implementation of clinical practice guidelines (CPGs) is likely to affect treatment costs. Methods: An important limitation of the extant literature on the cost effects of CPGs is tha...

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Bibliographic Details
Published in:International journal of technology assessment in health care 2006-01, Vol.22 (1), p.58-66
Main Authors: Schneider, John E., Peterson, N. Andrew, Vaughn, Thomas E., Mooss, Eric N., Doebbeling, Bradley N.
Format: Article
Language:English
Subjects:
Adaptation
Adoption
Business process reengineering
Changes
Chronic illnesses
Clinical decision making
Clinical medicine
Clinical outcomes
Clinical practice guidelines
Clinical Protocols
Cost analysis
Cost control
Cost effectiveness analysis
Cost reduction
Cost-Benefit Analysis
Economic efficiency
Evidence-based medicine
GENERAL ESSAYS
Guidelines
Health Care Costs
Health care expenditures
Health Facilities
Health services
Hospitals
Human resource management
Information management
Innovations
Length of stay
Literature reviews
Organizational change
Organizational Innovation
Physicians
Preventive medicine
Process innovation
Public health
Quality management
R&D
Research & development
Studies
Total quality
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Summary:Objectives: The overall objective of this article was to review the theoretical and conceptual dimensions of how the implementation of clinical practice guidelines (CPGs) is likely to affect treatment costs. Methods: An important limitation of the extant literature on the cost effects of CPGs is that the main focus has been on clinical adaptation. We submit that the process innovation aspects of CPGs require changes in both clinical and organizational dimensions. We identify five organizational factors that are likely to affect the relationship between CPGs and total treatment costs: implementation, coordination, learning, human resources, and information. We review the literature supporting each of these factors. Results: The net organizational effects of CPGs on costs depends on whether the cost-reducing properties of coordination, learning, and human resource management offset potential cost increases due to implementation and information management. Conclusions: Studies of the cost effects of clinical practice guidelines should attempt to measure, to the extent possible, the effects of each of these clinical and organizational factors.
ISSN:0266-4623
1471-6348
DOI:10.1017/S0266462306050847