Clinical pathways (CP) regarding stroke is a medical service standard necessitated ensuring quality health services at rational costs. The previous study showed that the effect of CP implication on hospitalization length has not shown conclusive results in one hospital nor considered the CP format used. Therefore, this study aims to measure the implication of ischemic stroke CP on hospitalization length. This study was conducted in public and private hospitals, type A and B, which run a stroke registry with uniformity in stroke care and CP format. A retrospective cohort design was used to measure the effectiveness of the ischemic stroke clinical pathway on the outcome of hospitalization length by controlling for confounding variables, including demographic factors, comorbidities, clinical, service procedure, and management support. The data source for the Ischemic Stroke CP group was obtained from the document in the hospital. The data of the without CP group was obtained from the Stroke Registry of the Research and Development Agency, and the medical record was traced to obtain the required variables. The population is ischemic stroke patients treated from January 2012-December 2015. The sample was selected purposively, meeting the inclusion and exclusion criteria, and the ischemic stroke diagnosis is based on medical records with ICD-X 163.9. The cut-off point for the length of hospitalization was determined by Receiver Operating Characteristic analysis, divided into 2 categories, long (>8 days) and short (≤8 days). Univariate, bivariate, stratification and multivariate analysis were performed using the Cox regression test. The results showed that 71% of the subjects were treated without CP, 65% had a short hospitalization length (<8 days), 39% were aged 18-55, and 57% were male. In men, 88% had dyslipidemia, 77% were admitted with mild severity as measured by the Glasgow Coma Scale (GCS = 15), and 35% had attack onset of admissions >24 h. The stratification test showed no interaction between the independent (CP) and the covariate variable on hospitalization length. Multivariate analysis found that CP significantly reduced the risk of hospitalization length (>8 days) by 53%, compared to patients treated without CP, after controlling for disease severity,

In the JKN-KIS era demanded quality and cost control. One appropriate tool is the implementation of clinical pathways and controlling costs per treatment activity based on the unit cost by activity based costing method, called the cost of treatment. On another aspect, faced with catastrophic diseases which cost a lot, not only for treatment but also for treatment in hospital and after discharge. Stroke is one of the catastrophic diseases which is did quality and cost control through the cost of treatment. Objective: The purpose of this study calculate cost of treatment of ischemic stroke based on clinical pathway and unit cost by activity based costing method. Methods: Type of this research was observational using cross sectional approach. The analysis units of this study was hospital "Bt" at year 2017. Data analysis using descriptive. Results: The results showed that cost of treatment of ischemic stroke on one care episode for 8 days was IDR 9.660.805. In detail, patient assessment was IDR 1.093.905, care treatment was IDR 785.489, medical support examination was IDR 1.407.414, medicines was IDR 3.081.333, medical rehabilitation was IDR 3.160.665, and nutrition consultation was IDR 132.000. The conclusion was cost of treatment of cerebral infarct based on clinical pathway and unit cost by activity based costing method higher than INA CBGs tariff.