醫院、醫師手術量與肝癌病人術後死亡率之關係

The Relationship between Hospital, Physician Volume and in-hospital Mortality for Patients with Hepatocellular Carcinoma

呂庭輝(Ting-Hui Lu) ； 楊長興(Chiang-Hsing Yang) ； 黃昱瞳(Yu-Tung Huang) ； 林明慧(Ming-Hui Lin)

《澄清醫護管理雜誌》 3卷1期 (2007/01) Pp. 46-51

https://doi.org/10.30156/CCMJ.200701.0007

摘要

Objectives: To examine whether there is an association between hospital, physician volume and in-hospital mortality for patients with hepatocellular carcinoma (HCC).
Methods: A cross-sectional research design was adopted. Data set was obtained from the National Health Research Institute, which is a three-year (1999-2001) claimed data on the National Health Insurance. Patients who underwent liver cancer resections were used for analysis. Logistic regression was employed for examining the relationship between hospital, physician volume and operative mortality for patients with HCC.
Results: Physician volume was inversely related to in-hospital mortality for patients with HCC (OR=0.65, P＜0.001).
Conclusions: Physician volume is a more important factor for in-hospital mortality for patients with HCC than hospital volume. Health report card concerning the outcome of care for HCC patients may be necessary for guiding the search for more cost-effectiveness and safer care.

關鍵字

醫院手術量 ； 醫師手術量 ； 醫師年資 ； 肝癌 ； 術後死亡率

並列摘要

Objectives: To examine whether there is an association between hospital, physician volume and in-hospital mortality for patients with hepatocellular carcinoma (HCC).
Methods: A cross-sectional research design was adopted. Data set was obtained from the National Health Research Institute, which is a three-year (1999-2001) claimed data on the National Health Insurance. Patients who underwent liver cancer resections were used for analysis. Logistic regression was employed for examining the relationship between hospital, physician volume and operative mortality for patients with HCC.
Results: Physician volume was inversely related to in-hospital mortality for patients with HCC (OR=0.65, P＜0.001).
Conclusions: Physician volume is a more important factor for in-hospital mortality for patients with HCC than hospital volume. Health report card concerning the outcome of care for HCC patients may be necessary for guiding the search for more cost-effectiveness and safer care.

並列關鍵字

hospital volume ； physician volume ； hepatocellular carcinoma ； in-hospital mortality