| Chen CH |
------>authors3_c=??? ------>paper_class1=1 ------>Impact_Factor=2.834 ------>paper_class3=2 ------>paper_class2=1 ------>vol=30 ------>confirm_bywho=None ------>insert_bywho=jane2 ------>Jurnal_Rank=21.0 ------>authors4_c=??? ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=30 ------>paper_class2Letter=None ------>page2=562 ------>medlineContent= ------>unit=E0100 ------>insert_date=20091020 ------>iam=3 ------>update_date=None ------>author=??? ------>change_event=1 ------>ISSN=0899-823X ------>authors_c=??? ------>score=500 ------>journal_name=Infection Control and Hospital Epidemiology ------>paper_name=Association between physician caseload and patient outcome for sepsis treatment. ------>confirm_date=None ------>tch_id=080006 ------>pmid=19419271 ------>page1=556 ------>fullAbstract=OBJECTIVE: The purpose of this study was to investigate whether physicians with larger sepsis caseloads provide better outcomes, defined as lower in-hospital mortality rates, for patients with sepsis. DESIGN: Retrospective cross-sectional study. METHOD: This study used pooled data from the 2002-2004 Taiwan National Health Insurance Research Database. A total of 48,336 patients hospitalized with a principal diagnosis of septicemia were selected and assigned to 1 of 4 caseload groups on the basis of their treating physician~s sepsis caseload during the 3 years reflected in the pooled data (low caseload, less than 39 cases; medium caseload, 39-88 cases; high caseload, 89-176 cases; and very high caseload, more than 176 cases). Generalized estimating equation models were used for analysis. RESULTS: Receipt of treatment from physicians in the very high, high, and medium caseload groups decreased patients~ odds of in-hospital mortality by 49% (95% confidence interval [CI], 0.41-0.67; P < .001), 40% (95% CI, 0.53-0.68; P < .001), and 18% (95% CI, 0.73-0.92; P < .001), respectively, compared with the odds for patients treated by low-caseload physicians. These findings persisted after partitioning out systematic physician-specific and hospital-specific variation and isolating the effects of most hospital, physician, and patient confounders. CONCLUSION: Patients treated by physicians who had a larger sepsis caseload had a substantially lower in-hospital mortality rate than did patients treated by physicians in the other caseload groups, and the difference was statistically significant. This result supports the "practice makes perfect" hypothesis. ------>tmu_sno=None ------>sno=22785 ------>authors2=Chen YH ------>authors3=Lin HC ------>authors4=Lin HC ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Chen CH ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c=??? ------>publish_area=0 ------>updateTitle=Association between physician caseload and patient outcome for sepsis treatment. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no=6 ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2009 ------>submit_flag=None ------>publish_month=6 |