Schepens M H J, Ziedses des Plantes C M P, Somford D M, van Erkelens J A, Cremers R G, de Vries S, Aben K K H, Hoekstra R, Stienen J J C, Wijsman B P, Busstra M B, van Limbeek J
Zorgverzekeraars Nederland, Zeist.
Ned Tijdschr Geneeskd. 2018;162:D2294.
To determine the effect of radical prostatectomy (RP) hospital volume on the probability of post-RP incontinence.
Retrospective research based on claims-based data of health insurers.
For every patient with RP the probability of incontinence was determined, based on the definition of claims of one or more incontinence pads per day. Casemix corrections were made based on indicators available in claims-data: age, lymph node dissection, and radiotherapy. No casemix corrections could be made for tumour stage and surgical technique.
A total of 1590 patients were included in this study; for 26.0% of these patients, an average of one or more incontinence pads per day were claimed for. A significant relation between the volume of RP per hospital and the claims of incontinence material was observed. The probability of incontinence was significantly lower in hospitals with a volume of more than 100 RP patients per year when compared to hospitals with less than 100 RP patients per year.
The probability of post-RP incontinence decreases as hospitals conduct more RP procedures. The casemix factors included in the analysis only had a limited impact on this observation.
确定根治性前列腺切除术(RP)的医院手术量对RP术后尿失禁概率的影响。
基于健康保险公司索赔数据的回顾性研究。
根据每天使用一个或多个尿失禁垫的索赔定义,确定每例接受RP手术患者的尿失禁概率。根据索赔数据中可用的指标进行病例组合校正:年龄、淋巴结清扫和放疗。无法对肿瘤分期和手术技术进行病例组合校正。
本研究共纳入1590例患者;其中26.0%的患者平均每天索赔一个或多个尿失禁垫。观察到每家医院的RP手术量与尿失禁材料索赔之间存在显著关系。与每年RP手术患者少于100例的医院相比,每年RP手术患者超过100例的医院尿失禁概率显著更低。
随着医院开展更多的RP手术,RP术后尿失禁的概率降低。分析中纳入的病例组合因素对这一观察结果的影响有限。