Lin HC |
------>authors3_c= ------>paper_class1=1 ------>Impact_Factor=5.391 ------>paper_class3=2 ------>paper_class2=1 ------>vol=38 ------>confirm_bywho=nwkuo ------>insert_bywho=henry11111 ------>Jurnal_Rank=4.8 ------>authors4_c= ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=1 ------>paper_class2Letter=None ------>page2=1569 ------>medlineContent= ------>unit=E0800 ------>insert_date=20070725 ------>iam=1 ------>update_date=None ------>author=??? ------>change_event=4 ------>ISSN= ------>authors_c= ------>score=500 ------>journal_name=Stroke ------>paper_name=Association between physician volume and hospitalization costs for patients with stroke in Taiwan: a nationwide population-based study. ------>confirm_date=20071114 ------>tch_id=090053 ------>pmid=17395867 ------>page1=1565 ------>fullAbstract=BACKGROUND AND PURPOSE: Past studies consistently show an inverse relationship between physicians~ surgical procedures/diagnoses volume and cost. There is little information available on this aspect of stroke care. We used nationwide population-based data to explore the association between physician case volume and costs per discharge for patients with stroke. METHODS: Data on all 83,748 hospitalizations for stroke in 2004, treated by 3757 physicians in Taiwan, from Taiwan~s National Health Insurance Research Database, was analyzed using hierarchical linear regression modeling to explore associations between costs per discharge and physician case volume (one to 44 cases=low volume, 44 to 135=medium volume, > or =136 cases=high volume) adjusting for patient~s age, gender, comorbidities, and stroke type; hospital ownership, teaching status, and geographic region; and physician demographics. RESULTS: Unadjusted mean cost per discharge was highest for patients treated by low-volume physicians, at NT $79,993 compared with NT $78,588 for medium-volume physicians and NT $43,942 for high-volume physicians (P<0.001). Adjusted for patient, hospital, and physician variables, low-volume physicians had a mean case cost of NT $27,729 higher than high-volume physicians (P=0.001) and NT $7761 higher than medium-volume physicians (P=0.027). CONCLUSIONS: Our data confirm an inverse volume-cost relationship for stroke care in Taiwan. After adjusting for patient, hospital, and physician characteristics, the potential cost savings if all patients were treated or supervised by high-volume physicians could be 41.0% of the mean treatment cost incurred by low-volume physicians. ------>tmu_sno=None ------>sno=15887 ------>authors2=Xirasagar S ------>authors3=Chen CH ------>authors4=Lin CC ------>authors5=Lee HC ------>authors6= ------>authors6_c= ------>authors=Lin HC ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=0 ------>updateTitle=Association between physician volume and hospitalization costs for patients with stroke in Taiwan: a nationwide population-based study. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no=5 ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2007 ------>submit_flag=None ------>publish_month=1 |