BACKGROUND: No study has explored the volume-outcome relationship for peptic ulcer treatment. OBJECTIVE: To investigate the association between peptic ulcer case volume per hospital, on the one hand, and in-hospital mortality and 14-day readmission rates, on the other, using a nationwide population-based dataset. DESIGN: A retrospective cross-sectional study, set in Taiwan. PARTICIPANTS: There were 48,250 peptic ulcer patients included. Each patient was assigned to one of three hospital volume groups: low-volume (< or = 189 case), medium volume (190-410 cases), and high volume (> or = 411 cases). MEASUREMENTS: Logistic regression analysis employing generalized estimating equations was used to examine the adjusted relationship of hospital volume with in-hospital mortality and 14-day readmission. MAIN RESULTS: After adjusting for other factors, results showed that the likelihood of in-hospital mortality for peptic ulcer patients treated by low-volume hospitals (mortality rate = 0.68%) was 1.6 times (p < 0.05) that of those treated in high-volume hospitals (mortality rate = 0.72%) and 1.4 times (p < 0.05) that of those treated in medium-volume hospitals (mortality rate = 0.73%). The adjusted odds ratio of 14-day readmission likewise declined with increasing hospital volume, with the odds of 14-day readmission for those patients treated by low-volume hospitals being 1.5 times (p < 0.001) greater than for high-volume hospitals and 1.3 times (p < 0.01) greater than for medium-volume hospitals. CONCLUSIONS: We found that, after adjusting for other factors, peptic ulcer patients treated in the low-volume hospitals had inferior clinical outcomes compared to those treated in medium-volume or high-volume ones.
BACKGROUND: No study has explored the volume-outcome relationship for peptic ulcer treatment. OBJECTIVE: To investigate the association between peptic ulcer case volume per hospital, on the one hand, and in-hospital mortality and 14-day readmission rates, on the other, using a nationwide population-based dataset. DESIGN: A retrospective cross-sectional study, set in Taiwan. PARTICIPANTS: There were 48,250 peptic ulcerpatients included. Each patient was assigned to one of three hospital volume groups: low-volume (< or = 189 case), medium volume (190-410 cases), and high volume (> or = 411 cases). MEASUREMENTS: Logistic regression analysis employing generalized estimating equations was used to examine the adjusted relationship of hospital volume with in-hospital mortality and 14-day readmission. MAIN RESULTS: After adjusting for other factors, results showed that the likelihood of in-hospital mortality for peptic ulcerpatients treated by low-volume hospitals (mortality rate = 0.68%) was 1.6 times (p < 0.05) that of those treated in high-volume hospitals (mortality rate = 0.72%) and 1.4 times (p < 0.05) that of those treated in medium-volume hospitals (mortality rate = 0.73%). The adjusted odds ratio of 14-day readmission likewise declined with increasing hospital volume, with the odds of 14-day readmission for those patients treated by low-volume hospitals being 1.5 times (p < 0.001) greater than for high-volume hospitals and 1.3 times (p < 0.01) greater than for medium-volume hospitals. CONCLUSIONS: We found that, after adjusting for other factors, peptic ulcerpatients treated in the low-volume hospitals had inferior clinical outcomes compared to those treated in medium-volume or high-volume ones.
Authors: T A Gordon; H M Bowman; E B Bass; K D Lillemoe; C J Yeo; R F Heitmiller; M A Choti; G P Burleyson; G Hsieh; J L Cameron Journal: J Am Coll Surg Date: 1999-07 Impact factor: 6.113
Authors: R H Jones; E L Hannan; K E Hammermeister; E R Delong; G T O'Connor; R V Luepker; V Parsonnet; D B Pryor Journal: J Am Coll Cardiol Date: 1996-11-15 Impact factor: 24.094
Authors: J G Jollis; E D Peterson; C L Nelson; J A Stafford; E R DeLong; L H Muhlbaier; D B Mark Journal: Circulation Date: 1997-06-03 Impact factor: 29.690
Authors: P D McGrath; D E Wennberg; J D Dickens; A E Siewers; F L Lucas; D J Malenka; M A Kellett; T J Ryan Journal: JAMA Date: 2000-12-27 Impact factor: 56.272
Authors: E L Hannan; M Racz; T J Ryan; B D McCallister; L W Johnson; D T Arani; A D Guerci; J Sosa; E J Topol Journal: JAMA Date: 1997-03-19 Impact factor: 56.272
Authors: Samuel Quan; Alexandra Frolkis; Kaylee Milne; Natalie Molodecky; Hong Yang; Elijah Dixon; Chad G Ball; Robert P Myers; Subrata Ghosh; Robert Hilsden; Sander Veldhuyzen van Zanten; Gilaad G Kaplan Journal: World J Gastroenterol Date: 2014-12-14 Impact factor: 5.742