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Obesity Surgery
Published in: Obesity Surgery 7/2012

01-07-2012 | Clinical Research

The Relationship between Volume and Outcome after Bariatric Surgery: A Nationwide Study in Taiwan

Authors: Chong-Chi Chiu, Jhi-Joung Wang, Tsung-Chih Tsai, Chin-Chen Chu, Hon-Yi Shi

Published in: Obesity Surgery | Issue 7/2012

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Abstract

Background

This study purposed to explore the impact of hospital volume and surgeon volume on hospital resource utilization after bariatric surgery and to identify the predictors of length of stay (LOS) and hospital treatment cost in a nationwide population in Taiwan.

Methods

This population-based cohort study retrospectively analyzed 2,674 bariatric surgery procedures performed from 1997 to 2008. Hospitals were classified as low- and high-volume hospitals if their annual number of bariatric surgeries were <35 and ≥35, respectively. Surgeons were classified as low- and high-volume surgeons if their annual number of bariatric surgeries were <15 and ≥15, respectively. Hierarchical linear regression models were used to predict LOS and hospital treatment cost.

Results

The mean LOS was 7.67 days and the LOS for high-volume hospitals/surgeons was, on average, 28%/31% shorter than that for low-volume hospitals/surgeons. The mean hospital treatment cost was US$2,344.08, and the average hospital costs for high-volume hospitals/surgeons were 10%/13% lower than those for low-volume hospitals/surgeons. Advanced age, male gender, high Charlson co-morbidity index, and current treatment in a low-volume hospital, by a low-volume surgeon, and via open gastric bypass were significantly associated with long LOS and high hospital treatment cost (P < 0.001).

Conclusions

The data suggest that annual surgical volume is the key factor in hospital resource utilization. The results improve the understanding of medical resource allocation for this surgical procedure and can help to formulate public health policies for optimizing hospital resource utilization for related diseases.
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Metadata
Title
The Relationship between Volume and Outcome after Bariatric Surgery: A Nationwide Study in Taiwan
Authors
Chong-Chi Chiu
Jhi-Joung Wang
Tsung-Chih Tsai
Chin-Chen Chu
Hon-Yi Shi
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 7/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0636-x

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