Clinical Pathways Based on Integrative Medicine in Chinese Hospitals Improve Treatment Outcomes for Patients with Acute Myocardial Infarction: A Multicentre, Nonrandomized Historically Controlled Trial

Objective. To determine the impact of an integrative medicine clinical pathways (CPs) on the length of in-hospital stay and on outcomes for patients with acute myocardial infarction (AMI).Methods. A multicenter nonrandomized controlled trial enrolling 197 consecutive patients with AMI at eight urban TCM hospitals was conducted between 1 January 2010 and 31 October 2010. These patients were enrolled in the interventional group after the CPs had been implemented. The control group included 405 patients with AMI from eight hospitals; these patients were treated between 1 January 2008 and 31 December 2009, before the CPs were implemented. Outcome measures were the length of hospital stay costs of medical care, and major cardiovascular events (MACEs) during hospitalization.Results. Compared with the control group, the patients in intervention group had a shorter length of hospital stay (9.2±4.2days versus12.7±8.6days,P<0.05), and reduced healthcare costs in hospital (46365.7±18266.9versus52866.0±35404.4,P<0.05). There were statistically significant differences in MACE between the two groups during the hospitalization period (2.5% versus 6.9%,P=0.03).Conclusion. These data suggest that the development and implementation of the clinical pathways based in Integrative Medicine could further improve quality of care and outcome for patients with AMI.