Supporting the evaluation of Clinical Pathways in rural China

Aug. 24, 2012

NICE International (NI) has been actively involved in the Chinese Rural Health Reforms since 2009. Its main counterpart in China is the China National Health Development and Research Centre (CNHDRC), a policy think-tank part of the Ministry of Health, which has over the years been leading on policy-orientated research projects of health strategy and health system reform; academic-based research of National Health Account and payment as well as health financial protection; and application-centred project of technology assessment and policy evaluation across China. This collaboration has so far been sponsored by DFID China.

In this latest part of the project, NI engaged in a series of activities, with the aim of informing CNHDRC and MoH’s evaluation of the Clinical Pathways (CP) project, particularly with regards to its impact on costs and also to its potential for saving costs without compromising outcomes, in the longer run, should it be rolled out across rural China county hospitals.

NI provided hands-on advice and support – as well as offering advice on areas for improvement – to the Chinese teams in 2 areas:

1. Costing and budget impact analysis support and training: The NI team worked closely with CNHDRC to support the field-work, in particular in relation to the types of costing data required to undertake full costing analyses at the end of the early stage of the evaluation.

2. Clinical feedback on CPs: During their stay in Beijing and their field trip to QianJian and Hanbin, the team had the opportunity to discuss the challenges and opportunities of implementing CPs in the pilot provinces, from the perspectives of the doctors’ and nurses’ working in the rural hospitals and also from the perspective of the Beijing tertiary hospital experts. The team also had the chance to observe clinicians as they delivered care, talk to the hospital administrators and local health authorities and also the IT and billing teams in the hospitals.

A full report has been submitted to CNHDRC and MoH for consideration and to inform the ongoing reforms. It was noted that the CP pilot is an exciting and highly ambitious project that, if successfully implemented, has the potential to drive significant quality and efficiency improvements across rural China.