• Maria Wahyu Daruki Faculty of Public Health, University of Indonesia
  • Atik Nurwahyuni Faculty of Public Health, University of Indonesia
  • Adang Bachtiar Faculty of Public Health, University of Indonesia


Background: Improving quality and efficiency in hospital services can be done by using Clinical Pathway (CP). CP can decrease the hospital length of stay and cost. In indonsia, the increasing number of Caesarean Section (SC) affects to the Length of Stay (LOS) in hospital. This study aims to examine the effectiveness of clinical pathway in caesaren section to length of stay in the hospital.

Methods: This study was a systematic review used PRISMA guidelines. Data obtained from Electronic journal databases Pubmed and ProQuest that published between 2014 until 2019 and used English language. By using keywords such as clinical pathway, childbirth labor, and length of stay to find the relevant journal.

Results: The search found out 4,937, studies from 2 journal databases. The articles that not suitable with the criteria inclusion must be exclude. Totally, 6 studies were analyzed in this study. 1 study explained the affect of increasing length of stay in the National Health Insurance, 2 studies mentioned that CP was not affected to the length of stay in hospital and 3 studies mentioned that CP was reduced the length of stay in hospital. 

Conclusion: Clinical pathway in Caesarean section can reduced the length of stay in hospital. The hospital should implement the clinical pathway in caesarean section to increase the quality of hospital service and reduce the cost.

Keywords: Clinical Pathway, Childbirth Labor, Length of Stay, Casearean Section


Nurwahyuni A, Sjaaf AC, Hapsari WP, Nugraha RR. Compliance with Clinical Pathway for Cesarean Section after Implementation of JKN in Hospital X. In the 2nd International Conference on Hospital Administration. KnE Life Sciences; 2018. p29-40

Kawakita T, Landy HJ. Surgical site infections after cesarean delivery: epidemiology, prevention and treatment. Maternal Health, Neonatology, and Perinatology Journal. USA: Creative Common Public; 2017

Hassan M, Tuckman HP, Patrick RH, Kountz DS, Kohn JL. Hospital length of stay and probability of acquiring infection. International Journal of Pharmaceutical and Healthcare Marketing Vol. 4 No. 4: USA: Emerald Group Publishing Limited; 2010. p324-338

Kim SJ, Han KT, Park EC. Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. nonspecialty hospitals in South Korea. PLOS One Journal: Japan; 2017. p5

Campbell OMR, Cegolon L, Macleod D, Benova L. Length of Stay After Childbirth in 92 Countries and Associated Factors in 30 Low- and Middle-Income Countries: Compilation of Reported Data and a Cross-sectional Analysis from Nationally Representative Surveys. PLOS Medicine Journal. United Kingdom; 2016.

Aniza I, Saperi S, Zafar A, Aljunid SM, Wan Norlida I, Oteh M, Husyairi H, Ismail S, Nor Hamdan Y, Faizal AH, Hassan MYS, Hamat H. Implementation of Clinical Pathways in Malaysia: Can Clinical Pathways Improve the Quality of Care?. International Medical Journal Vol. 23, No. 1. Japan: Japan Health Sciences University & Japan International Cultural Exchange Foundation; 2016. p47-50

Bai J, Bai F, Zhu H, Xue D. The perceived and objectively measured effects of clinical pathways’ implementation on medical care in China. PLOS One. China; 2018. p1-13

Schrijvers G, Hoorn A, Huiskes N. The care pathway: concepts and theories: an introduction. International Journal of Integrated Care. Vol. 12 : Special Edition Integrated Care Pathways. Utrecht: Igitur Publishing; 2012.

Jingwei AH, Yang W. Clinical pathways in China – an evaluation. International Journal of Health Care Quality Assurance Vol. 28 No. 4; 2015. p394-411.

Haninditya B, Andayani TM, Yasin NM. Analysis of Cesarean Section Clinical Pathway Compliance at a Private Hospital in Yogyakarta. JMPF Journal Vol. 9 No. 1. Yogyakarta: Gadjah Mada University; 2019. p38-45

Purbaningsih A, Pujiyanto, Sari K, Nurwahyuni A. Length of Hospital Stay in Different Health Insurance Payment Systems. Knowledge E Life Sciences Journal; 2018. p330.

Saputra M, Marlinae L, Rahman L, Rosadi D. National Health Insurance Program from the Aspect of Human Resources Implementation of Health Services. Jurnal Kesehatan Masyarakat. Jakarta; 2015. p2

Cegolon L, Mastrangelo G, Campbell OM, Giangreco M, Alberico S, Montasta L, Ronfani L, Barbone F. Length of stay following cesarean sections: A population based study in the Friuli Venezia Giulia region (North-Eastern Italy), 2005-2015. PLOS One Journal: 2019.

Corso E, Hind D, Beever D, Fuller G, Wilson MJ, Wrench IJ, Chambers D. Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy and Childbirth; 2017. p17-91

Daalen FV, Prins JM, Opmeer BC, Boermeester MA, Visser CE, Hest RM, Branger J, Mattsson E, Broek MFM, Roeleveld TC, Karimbeg AA, Haak EAF, Hout HC, Agtmael MA, Hulscher MEJL, Geerlings SE. Effect of an antibiotic checklist on length of hospital stay and appropriate antibiotic use in adult patients treated with intravenous antibiotics: a stepped wedge cluster randomized trial. Clinical Microbiology and Infection Journal. Amsterdam: Elsevier; 2017. p485.

Ahsan. Assessing Patient-Care Knowledge and Practice to Prevent Nosocomial Infection Post-Caesarean Section in District Hospitals. Asian Journal of Pharmacy, Nursing and Medical Sciences Volume 3; 2015.

Liua R, Shic J, Yange B, Jin C, Sund P, Wuf L, Yuc D, Xionga L, Wang Z. Charting a path forward: policy analysis of China’s evolved DRG-based hospital payment system. Int Health. Oxford University Press; 2017. p317–324.

Corso E, Hind D, Beever D, Fuller G, Wilson MJ, Wrench IJ, Chambers D. Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy and Childbirth Journal. United Kingdom : The Authors; 2017. p3

National Institute for Health and Care Excellence. Care after caesarean section. NICE Pathways. United Kingdom : NICE; 2019.

Ibrahim WH, Makhlouf AM, Khamis MA, Youness EM. Effect of prophylactic antibiotics (Cephalosporin versus Amoxicillin) on

preventing post caesarean section infection. Journal of American Science. USA : American Science; 2011. p178.



How to Cite

Daruki, M. W., Nurwahyuni, A., & Bachtiar, A. (2019). EFFECTIVENESS OF CAESAREAN SECTION CLINICAL PATHWAY TOWARDS HOSPITAL LENGTH OF STAY: A SYSTEMATIC REVIEW. Proceedings of the International Conference on Applied Science and Health, (4), 798–808. Retrieved from https://publications.inschool.id/index.php/icash/article/view/702




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