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標題Title: The Relationship between Volume and Outcome after Bariatric Surgery: A Nationwide Study in Taiwan
作者Authors: 趙頌慈
上傳單位Department: 電機工程系
上傳時間Date: 2015-12-31
上傳者Author: 趙頌慈
審核單位Department: 電機工程系
審核老師Teacher: 趙頌慈
檔案類型Categories: 論文Thesis
關鍵詞Keyword: Bariatric surgery, Volume, Lengths of stay, Hospital treatment cost
摘要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 highvolume
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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