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http://dx.doi.org/10.5090/kjtcs.2016.49.S1.S20

The Association Between Treatment Frequency and Treatment Outcome for Cardiovascular Surgeries  

Choi, Ji Suk (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service)
Park, Choon Seon (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service)
Kim, Myunghwa (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service)
Kim, Myo Jeong (Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service)
Lee, Kun Sei (Department of Preventive Medicine, Konkuk University School of Medicine)
Sim, Sung Bo (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Chee, Hyun Keun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine)
Park, Nam Hee (Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine)
Park, Sung Min (Thoracic and Cardiovascular Surgery, Kangwon National University Hospital)
Publication Information
Journal of Chest Surgery / v.49, no.sup1, 2016 , pp. 20-27 More about this Journal
Abstract
Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.
Keywords
Thoracic surgery; Volume-outcome relationship; Quality of health care;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
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1 Yoon SJ, Park CS, Kim MH, et al. Study on the management of cardio-cerebrovascular disease and feasibility evaluation of regional cardiovascular surgery center. Wonju: Health Insurance Review and Assessment Service; 2015.
2 Hannan EL, Kilburn H Jr, Bernard H, O'Donnell JF, Lukacik G, Shields EP. Coronary artery bypass surgery: the relationship between inhospital mortality rate and surgical volume after controlling for clinical risk factors. Med Care 1991;29:1094-107.   DOI
3 Post PN, Kuijpers M, Ebels T, Zijlstra F. The relation between volume and outcome of coronary interventions: a systematic review and meta-analysis. Eur Heart J 2010;31:1985-92.   DOI
4 Rathore SS, Epstein AJ, Volpp KG, Krumholz HM. Hospital coronary artery bypass graft surgery volume and patient mortality, 1998-2000. Ann Surg 2004;239:110-7.   DOI
5 Ricciardi R, Virnig BA, Ogilvie JW Jr, Dahlberg PS, Selker HP, Baxter NN. Volume-outcome relationship for coronary artery bypass grafting in an era of decreasing volume. Arch Surg 2008;143:338-44.   DOI
6 Khang YH, Kim YI, Kim CY, et al. Relationship between percutaneous transluminal coronary angioplasty volume and associated immediate outcome. Korean J Prev Med 2001;34:9-20.
7 Lee KS, Lee SI. Does a higher coronary artery bypass graft surgery volume always have a low in-hospital mortality rate in Korea? J Prev Med Public Health 2006;39:13-20.
8 Lin HC, Xirasagar S, Tsao NW, Hwang YT, Kuo NW, Lee HC. Volume-outcome relationships in coronary artery bypass graft surgery patients: 5-year major cardiovascular event outcomes. J Thorac Cardiovasc Surg 2008;135:923-30.   DOI
9 Peterson ED, Coombs LP, DeLong ER, Haan CK, Ferguson TB. Procedural volume as a marker of quality for CABG surgery. JAMA 2004;291:195-201.   DOI
10 Nallamothu BK, Eagle KA, Ferraris VA, Sade RM. Should coronary artery bypass grafting be regionalized? Ann Thorac Surg 2005;80:1572-81.   DOI
11 Chassin MR. Achieving and sustaining improved quality: lessons from New York State and cardiac surgery. Health Aff (Millwood) 2002;21:40-51.   DOI
12 Cho WC, Yoo DG, Kim JB, et al. Aortic valve replacement for aortic stenosis and concomitant coronary artery bypass: long-term outcomes and predictors of mortality. Korean J Thorac Cardiovasc Surg 2011;44:131-6.   DOI
13 Chung ES, Park KH, Lim C, Choi J. Risk factors of red blood cell transfusion in isolate off pump coronary artery bypass surgery. Korean J Thorac Cardiovasc Surg 2012;45:301-7.   DOI