| Lin HC |
------>authors3_c= ------>paper_class1=1 ------>Impact_Factor=5.947 ------>paper_class3=2 ------>paper_class2=1 ------>vol= ------>confirm_bywho=nwkuo ------>insert_bywho=henry11111 ------>Jurnal_Rank=11.1 ------>authors4_c= ------>comm_author=1 ------>patent_EDate=None ------>authors5_c= ------>publish_day=1 ------>paper_class2Letter=None ------>page2= ------>medlineContent= ------>unit=E0800 ------>insert_date=20080721 ------>iam=1 ------>update_date=None ------>author=??? ------>change_event=4 ------>ISSN= ------>authors_c= ------>score=447 ------>journal_name=Journal of Thrombosis and Haemostasis ------>paper_name=Volume-Outcome Relation for Pulmonary Embolism Treatment: Association between Physician and Hospital Volume and 30-day Mortality ------>confirm_date=20080807 ------>tch_id=090053 ------>pmid=18662261 ------>page1= ------>fullAbstract=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 >or=7 cases (high volume), while the three hospital volume groups were <42 cases (low volume), 42-110 cases (medium volume) and >or=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. ------>tmu_sno=None ------>sno=18739 ------>authors2=Lee HC ------>authors3= ------>authors4= ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Lin HC ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=0 ------>updateTitle=Caseload volume-outcome relation for pulmonary embolism treatment: association between physician and hospital caseload volume and 30-day mortality. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no= ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2008 ------>submit_flag=None ------>publish_month=1 |