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The Association Between Treatment Frequency and Treatment Outcome for Cardiovascular Surgeries
Ji Suk Choi1, Choon Seon Park1, Myunghwa Kim1
1Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service.
Insights
Higher heart surgery volume in hospitals is linked to better patient survival rates. Hospitals performing over 200 surgeries annually showed significantly lower mortality compared to those performing fewer than 50.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Medical Quality Improvement
Background:
- Analysis of the relationship between hospital heart surgery volume and patient outcomes.
- Focus on data from the last five years to assess current trends.
Purpose of the Study:
- To investigate the correlation between the annual volume of heart surgeries performed by a hospital and its patient treatment outcomes.
- To identify thresholds in surgical volume that impact mortality rates.
Main Methods:
- Utilized data from the Health Insurance Review and Assessment Service for Korean hospitals performing heart surgeries.
- Defined treatment outcome as 30-day postoperative mortality and categorized annual surgical volume.
- Employed logistic regression analysis to assess variable impacts on outcomes.
Main Results:
- Hospitals performing 50+ heart surgeries annually demonstrated lower mortality rates than those performing fewer.
- A significant decrease in mortality was observed as annual surgical volume increased.
- Hospitals with over 200 annual surgeries had less than half the mortality rate of those with 49 or fewer.
Conclusions:
- A substantial volume of heart surgery experience is crucial for maintaining and improving surgical quality.
- Policy interventions supporting collaboration between smaller and experienced hospitals are recommended to enhance outcomes in less experienced facilities.
Background:
This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years.
Methods:
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.
Results:
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.
Conclusion:
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.
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