Improving care pathways through evidence-based modeling strategies: a scoping review

Abstract

Objectives: Noncommunicable and communicable diseases represent significant public health problems, heavily straining healthcare systems. The care pathway (CP) concept has emerged as a promising framework to improve care coordination and delivery, but its complexity often hinders implementation. Modeling, with its various methodologies, represents a valuable approach to address this challenge. Systematizing these methodologies is essential for enhancing CPs. This scoping review aims to describe and analyze CP modeling methodologies.

Study design: Scoping review.

Methods: Following PRISMA-ScR guidelines, searches were performed in PubMed, Web of science and Embase. Inclusion criteria were: (i) publications in English; (ii) human studies, (iii) published between January 1, 2019 and April 3, 2024 and (iv) use of modeling to analyze CPs. For each publication included, data were extracted and categorized based on modeling goals, methods used, functions of the techniques and their respective strengths and limitations.

Results: Analysis of the 41 included articles revealed that the main goals of CP modeling were quality of care (46.3 %), continuous improvement (31.7 %), and process optimization (22.0 %). The methods used for modeling were qualitative (41.5 %), quantitative (34.1 %), or mixed (24.4 %). Technical goals were description (48.8 %), decision support (36.6 %), and prediction (14.6 %). Qualitative methods (68.5 %) were common in studies focused on quality of care. Only 11 articles shared similar methodologies across at least two studies. Key weaknesses of CP modeling were data availability and implementation acceptance.

Conclusions: This scoping review identified key categories and commonly used methodologies in CP modeling, offering a framework to help researchers and healthcare professionals improve CP design and implementation, leading to better patient outcomes and more efficient healthcare systems.

Keywords: Care improvement; Care management; Modeling framework; Process optimization; Quality of care.