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Published in: Journal of General Internal Medicine 10/2008

01-10-2008 | Original Article

Hospital Case Volume and Clinical Outcomes for Peptic Ulcer Treatment

Authors: Horng-Yuan Lou, MD, Herng-Ching Lin, PhD, Kuan-Yang Chen, MD

Published in: Journal of General Internal Medicine | Issue 10/2008

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Abstract

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 (≤189 case), medium volume (190–410 cases), and high volume (≥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.
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Metadata
Title
Hospital Case Volume and Clinical Outcomes for Peptic Ulcer Treatment
Authors
Horng-Yuan Lou, MD
Herng-Ching Lin, PhD
Kuan-Yang Chen, MD
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 10/2008
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-008-0721-y

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