Heliyon (Jun 2024)
Clinical pathways for Korean medicine: An implementation approach to impact on the clinical process and association with attitudes
Abstract
Background: South Korea's Ministry of Health and Welfare has developed clinical pathways for Korean Medicine (KM-CPs). As part of this initiative, a panel comprising Korean Medicine doctors (KMD) was assembled. This implementation study aimed to preliminarily explore how KM-CP implementation affects the appropriateness and efficiency of the clinical process and its relation to attitude. Methods: Through random sampling, 311 KMDs were recruited as panelists to participate in two surveys. The surveys included information regarding the KM clinical environment and KM-CP implementation. A panel management program and educational materials were provided to KMDs between the two survey periods. Only 262 KMDs who responded to both surveys were included in the analysis. Three analyses were conducted: 1) descriptive analysis of the study variables, 2) panel analysis using the ordered logit regression model to elucidate the impact of KM-CP on the appropriateness and efficiency of the clinical process, and 3) ordered logit regression analysis of the association between KM-CP implementation and attitude. Results: More than two-thirds of the KMDs attempted to adopt KM-CP, with mostly positive perception expressed by these doctors. However, expectations and concerns coexist with the standardization of KM-CP. Cases in which KM-CPs were partially and mostly implemented respectively had negative and positive effects on the appropriateness and efficiency of the clinical process compared to those in which KM-CPs were not implemented. Compared to neutral attitude, positive and very positive attitudes tended to be associated with increased implementation of KM-CP. However, statistical significances were not observed. Conclusions: The impact of KM-CP on the clinical process and its association with attitude were found to be statistically unclear or inconsistent. Considering the study limitations and implications, we suggest a policy and academic strategies aimed at fostering improvement to enhance its utility.
