Application of Four Types of Korean Medicine Critical Pathways for Lumbar Herniated Intervertebral Disc to Korean Medicine Institutions

Abstract

Background: Lumbar herniated intervertebral disc (L-HIVD) is a common disease among patients visiting Korean medicine institutions. This study aimed to apply the critical pathway (CP) and improve its practical use in actual integrative medicine hospitals, Korean medicine hospitals, and Korean medicine clinics. Methods: CP application, completion, and effectiveness were analyzed by integrative medicine hospitals, Korean medicine hospitals, and Korean medicine clinics. At each institution, the CP application and completion rates were analyzed for all patients with CP-eligible diseases. The utility of the CP application was also analyzed by dividing the baseline statistics for each major indicator for all patients into groups that completed the CP application and those that did not. Moreover, the utility of the CP application was analyzed by dividing the major baseline statistics by hospital/clinic level and inpatient/outpatient into the CP application completed and uncompleted groups. Results: At each institution, all participants were stratified into the CP completed or uncompleted groups. In the completed group, analysis of the clinical index values before and after the CP application yielded significant results in the numeral rating scale-axial pain, numeral rating scale-radiculopathy, Oswestry disability index, and Euroqol 5-dimensions 5-levels, in which a decrease was observed (p < 0.05). Conclusion: CP was employed for L-HIVD, and a significant decline in clinical values was observed for the CP completed group in comparison with the uncompleted group. The application of CP unveiled its advantages and limitations, and these will be applied in future clinical trials.

Keywords

• critical pathway
• integrative medicine hospital
• korean medicine clinic
• lumbar herniated intervertebral disc