Lin Herng-Ching, Chu Chien-Heng, Lee Hsin-Chien
Int J Cardiol. 2009 May 15;134(2):288-90. doi: 10.1016/j.ijcard.2007.12.071. Epub 2008 Mar 25.
This study sets out to assess the relationship between in-hospital mortality rates and physician acute myocardial infarction (AMI) volume, along with an examination of the impact of physician specialty on in-hospital mortality rates in Taiwan. Analysis was undertaken on a total of 19,086 patients hospitalized for AMI, following the division of the sample patients into four roughly equivalent groups. Within each physician specialty, the AMI patients were also subsequently grouped into four roughly equivalent groups based upon physician volume. After adjusting for other factors, the likelihood of in-hospital mortality among patients treated by low-volume physicians was 2.141 (p<0.001) times as high as that for patients treated by high-volume physicians, and 2.410 (p<0.001) times as high as that for patients treated by very high-volume physicians. However, while such an inverse relationship was found to persist for those physicians specializing in general internal medicine and 'others', this was not the case for cardiologists.
本研究旨在评估台湾地区住院死亡率与医生急性心肌梗死(AMI)诊疗量之间的关系,并考察医生专业对住院死亡率的影响。对总共19086例因AMI住院的患者进行分析,将样本患者分为四个大致相等的组。在每个医生专业内,AMI患者随后也根据医生诊疗量分为四个大致相等的组。在对其他因素进行调整后,低诊疗量医生治疗的患者院内死亡可能性是高诊疗量医生治疗患者的2.141倍(p<0.001),是极高诊疗量医生治疗患者的2.410倍(p<0.001)。然而,虽然发现这种反比关系在普通内科医生和“其他”专业医生中持续存在,但心脏病专家并非如此。