[Investigation on the changes in the hospitalization period after the induction of new discharge criteria for pulmonary tuberculosis--utility of assessment sheet for using clinical path].

2007 
PURPOSE AND METHODS: The new discharge criteria devised by the National Hospital Organization have three patterns (A, B and other). It was predicted that the hospitalization period would be markedly shortened by the pattern A. In order to judge whether these patterns were adequately applied, we used an assessment sheet. We investigated the adoption rate of the pattern A and the changes in the hospitalization period after its induction. RESULTS: There was a low adoption rate for the pattern A; namely 18%, and the main reasons for not following it were severity illness and the presence of complications. Hospitalization for less than 4 weeks was seen in 25%, while it was over 8 weeks in 42%. The average period of hospitalization was shortened by 20 days and the average number of patients per day also decreased. CONCLUSION: Interpretation of discharge criteria is standardized by using the assessment sheet, allowing us to perform smooth induction of a clinical path and guide patients along it. Shortening of hospitalization raises patient turnover and allows more rational management of pulmonary tuberculosis. These results could help to refine the clinical path in the future.
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