Choi Ji Suk, Park Choon Seon, Kim Myunghwa, Kim Myo Jeong, Lee Kun Sei, Sim Sung Bo, Chee Hyun Keun, Park Nam Hee, Park Sung Min
Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
Department of Preventive Medicine, Konkuk University School of Medicine.
Korean J Thorac Cardiovasc Surg. 2016 Dec;49(Suppl 1):S20-S27. doi: 10.5090/kjtcs.2016.49.S1.S20. Epub 2016 Dec 5.
This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years.
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.
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.
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.
本研究分析了过去五年医院心脏手术量与治疗结果之间的关联。
通过健康保险审查与评估服务机构,选取韩国各地进行心脏手术的医院作为研究对象。心脏手术的治疗结果定义为术后30天内的死亡率,同时对手术年手术量进行分类。采用逻辑回归作为统计分析方法,进而分析各变量对心脏手术治疗结果的影响。
在每年进行50例或更多手术的医院接受手术的患者死亡几率明显低于在每年进行少于50例手术的医院接受手术的患者,这表明随着医院心脏手术年手术量的增加,死亡几率降低。特别是,每年进行超过200例手术的医院的死亡率不到每年进行49例或更少手术的医院的一半。
这些结果表明,积累一定水平的心脏手术经验对于提高或维持心脏手术质量至关重要。为了改善小型医院的治疗结果,必须实施一项支持政策,允许与经验丰富的专业人员合作。