[Standardized treatment].

Abstract

Treatment protocols have not been well-defined, and may comprise anything from mere instructions regarding simple procedures to guide-lines for the treatment of the whole course of a disease. The discussion about treatment protocols has continued on since the 70's, and the system has been introduced into the Health Service of a number of countries. Those in favour of the programmes have focused, in particular, on the economic advantages and the advantage of achieving a certain quality of treatment, while those opposing the programmes insist that clinical freedom is at stake. We have found, especially via literature studies, that little knowledge is available as to what extent treatment protocols or case management protocols are employed, e.g., in Sweden and the USA where there have been a number of advocates of these systems. We have only been able to find two evaluation studies of more comprehensive programmes. In these two studies, the total expenditure for treatment was not clearly reduced, and as there were no well-defined parameters for quality of care, it has not been possible to demonstrate any improvement in the quality itself. It is, of course, possible that the discussion in respect of treatment protocols has indirectly had an effect on clinical thought, including those countries where these systems have not been introduced.