Volume-Outcome Relation for Pulmonary Embolism Treatment: Association between Physician and Hospital Volume and 30-day Mortality

English | 正體中文 | 简体中文 | 全文筆數/總筆數 : 45346/58522 (77%)
造訪人次 : 2504923 線上人數 : 166

RC Version 7.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.

Taipei Medical University Institutional Repository > 管理學院 > 醫務管理學系暨研究所 > 期刊論文 > Item 987654321/2244

請使用永久網址來引用或連結此文件: http://libir.tmu.edu.tw/handle/987654321/2244

題名:	Volume-Outcome Relation for Pulmonary Embolism Treatment: Association between Physician and Hospital Volume and 30-day Mortality
作者:	林恆慶 Lin HC;Lee HC
貢獻者:	醫務管理學系
日期:	2008
上傳時間:	2009-08-18 16:29:29 (UTC+8)
摘要:	Summary. Objective: This study sets out to examine the association between physician and hospital pulmonary embolism (PE) caseload volume and subsequent patient outcomes using 3-year nationwide population-based data in Taiwan. Method: This study used claims data from the 2002–2004 National Health Insurance Research Database. The sample of 2761 PE inpatients was divided into three physician caseload volume groups, <3 cases (low volume), 3–6 cases (medium volume) and ‡7 cases (high volume), while the three hospital volume groups were <42 cases (low volume), 42–110 cases (medium volume) and ‡111 cases (high volume). A conditional logistic regression model was performed to evaluate the effects of caseload volume on 30-day mortality for PE treatment. Results: Patients treated by low case volume physicians had significantly higher mortality rates than those treated by medium case volume (19.0% vs. 13.3%, P < 0.001) or high case volume physicians (19.0% vs. 8.4%, P < 0.001). However, no significant relationship was observed between 30-day morality and hospital caseload volume (P = 0.697). The regression shows that the adjusted odds of 30-day mortality among patients of low case volume physicians were over twice the mortality odds among patients of high case volume physicians (OR = 2.164, P < 0.001), and odds ratios were 1.401 relative to medium case volume physicians patients (P < 0.05). Conclusion: We conclude that an inverse PE volume-outcome relationship does exist for physicians, but not for hospitals. The skill or experience of an individual physician is a more critical factor than hospital equipment, infrastructure or staffing team in determining PE patient outcomes. Keywords: 30-day mortality, pulmonary embolism, volumeoutcome.
關聯:	Journal of Thrombosis and Haemostasis.
資料類型:	article
顯示於類別:	[醫務管理學系暨研究所] 期刊論文

文件中的檔案:

檔案	描述	大小	格式	瀏覽次數
38.pdf		89Kb	Adobe PDF	88	檢視/開啟
全文.txt		0Kb	Text	366	檢視/開啟

在TMUIR中所有的資料項目都受到原著作權保護.

TAIR相關文章

著作權聲明 Copyright Notice

本平台之數位內容為臺北醫學大學所收錄之機構典藏，包含體系內各式學術著作及學術產出。秉持開放取用的精神，提供使用者進行資料檢索、下載與取用，惟仍請適度、合理地於合法範圍內使用本平台之內容，以尊重著作權人之權益。商業上之利用，請先取得著作權人之授權。
The digital content on this platform is part of the Taipei Medical University Institutional Repository, featuring various academic works and outputs from the institution. It offers free access to academic research and public education for non-commercial use. Please use the content appropriately and within legal boundaries to respect copyright owners' rights. For commercial use, please obtain prior authorization from the copyright owner.
瀏覽或使用本平台，視同使用者已完全接受並瞭解聲明中所有規範、中華民國相關法規、一切國際網路規定及使用慣例，並不得為任何不法目的使用TMUIR。
By utilising the platform, users are deemed to have fully accepted and understood all the regulations set out in the statement, relevant laws of the Republic of China, all international internet regulations, and usage conventions. Furthermore, users must not use TMUIR for any illegal purposes.
本平台盡力防止侵害著作權人之權益。若發現本平台之數位內容有侵害著作權人權益情事者，煩請權利人通知本平台維護人員([email protected])，將立即採取移除該數位著作等補救措施。
TMUIR is made to protect the interests of copyright owners. If you believe that any material on the website infringes copyright, please contact our staff([email protected]). We will remove the work from the repository.

資料載入中.....