Clinical Pathway–Based Quality and Cost Control in Type D Hospitals: A Practical and Ethical Framework

Abstract

Hospitals operating under universal health coverage face increasing pressure to balance quality of care, patient safety, and cost efficiency, particularly in resource-limited settings. This paper proposes a practical and ethical framework for quality and cost control in Type D hospitals using clinical pathways as the core operational instrument. A policy and practice approach was adopted, drawing on professional experience in hospital clinical governance and management. Clinical pathways standardize care processes, reduce unnecessary variation, support rational use of generic and locally produced medicines, and strengthen patient safety without compromising quality. Clinical pathway–based quality and cost control offers an ethically sound and operationally feasible approach for hospitals operating under case-based reimbursement systems.