JMIR Publications

ABSTRACT

Background:

The healthcare system faces challenges of inconsistent quality, inefficiency, and rising costs. Fragmented applications of Clinical Decision Support Systems (CDSS), Clinical Pathways (CP), and Diagnosis-Related Group (DRG) payment systems have limited their synergistic potential.

Objective:

This study proposed a "CDSS-CP-DRG" closed-loop model enabled by digital health technologies, CDSS optimized CP execution through real-time data, CP standardized workflows to support DRG cost control, and DRG payment pressures drove iterative improvements in both technology and processes. This research aimed to validate the model's effectiveness in clinical efficacy, cost control and standardized diagnosis and treatment of bronchopneumonia in children, and provided evidence for value-based healthcare transformation.

Methods:

A total of 4543 children with bronchopneumonia were included and divided into experimental and control groups based on IDCS system utilization duration. Chi-square test, one-way analysis of variance, paired t test, multiple regression analysis and other mathematical statistical methods were used to verify the difference between the outcomes of the two groups of researchers.

Results:

This study demonstrated comparably high cure rates in both groups (p> 0.05). However, the experimental group exhibited a 0.41-day reduction in average length of stay (LOS), 12.25% lower total hospitalization costs, RMB 135.52 higher medical insurance reimbursement surplus, and 0.16 defined daily doses (DDD) reduction in antibiotic use intensity versus the control group (p < 0.05 for all significant differences).

Conclusions:

The novel IDCS demonstrates significant improvement significance in the clinical effect, cost control and standardized treatment on pediatric bronchopneumonia, but the CP for pediatric pneumonia requiring intensive care still needs further attention and adjustment.