지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Background: The volume of surgery has been examined as a major source of variation in outcome after surgery. This study investigated the direct effect of surgery volume to in hospitals mortality and the moderating effect of structural complexity-the level of diversity and sophistication of technology a hospital applied in patient care-to the volume outcome relationship. Methods: Discharge summary data of 11,827 cancer patients who underwent surgery and were discharged during a month period in 2010 and 2011 were analyzed. The analytic model included the independent variables such as surgery volume of a hospital, structural complexity measured by the number of diagnosis a hospital examined, and their interaction term. This study used a hierarchical logistic regression model to test for an association between hospital complexity and mortality rates and to test for the moderating effect in the volume outcome relationship. Results: As structural complexity increased the probability of in-hospital mortality after cancer surgery reduced. The interaction term between surgery volume and structural complexity was also statistically significant. The interaction effect was the strongest among the patients group who had surgery in low volume hospitals. Conclusion: The structural complexity and volume of surgery should be considered simultaneously in studying volume outcome relationship and in developing policies that aim to reduce mortality after cancer surgery.
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참고문헌 (34)
참고문헌 신청
Birkmeyer JD / 2002 / Hospital volume and surgical mortality in the United States / N Engl J Med 346(15):1128~1137
Kim MG / 2014 / Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center / Surg Endosc 28(5):1563~1570
Damle RN / 2014 / Surgeon volume and elective resection for colon cancer: an analysis of outcomes and use of laparoscopy / J Am Coll Surg 218(6):1223~1230
Joseph B / 2009 / Relationship between hospital volume, system clinical resources, and mortality in pancreatic resection / J Am Coll Surg 208(4):520~527
McPhee JT / 2011 / Surgeon case volume, not institution case volume, is the primary determinant of in-hospital mortality after elective open abdominal aortic aneurysm repair / J Vasc Surg 53(3):591~599
Kim MG / 2014 / Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center / Surg Endosc 28(5):1563~1570
Damle RN / 2014 / Surgeon volume and elective resection for colon cancer: an analysis of outcomes and use of laparoscopy / J Am Coll Surg 218(6):1223~1230
Joseph B / 2009 / Relationship between hospital volume, system clinical resources, and mortality in pancreatic resection / J Am Coll Surg 208(4):520~527
McPhee JT / 2011 / Surgeon case volume, not institution case volume, is the primary determinant of in-hospital mortality after elective open abdominal aortic aneurysm repair / J Vasc Surg 53(3):591~599
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