Effect of hospital volume on in-hospital mortality with pancreaticoduodenectomy
Effect of hospital volume on in-hospital mortality with pancreaticoduodenectomy
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DOI：
10.1016/s0039-6060(99)70234-5
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发表时间：
1999-03-01
期刊：
影响因子：
3.8
通讯作者：
Fisher, ES
中科院分区：
文献类型：
--
作者：
Birkmeyer, JD;Finlayson, SRG;Fisher, ES
背景。有报道称，国家转诊中心的治疗效果优于小容量社区医院，这促使人们呼吁将胰十二指肠切除术（惠普尔手术）地区化。我们研究了美国所有医院的医院容量和死亡率之间的关系。利用医疗保险索赔数据库的信息，我们对7229名在1992年至1995年间接受胰十二指肠切除术的65岁以上的医疗保险患者进行了一项全国性队列研究。我们根据医院在医疗保险患者中进行胰十二指肠切除术的平均年量将研究人群大致分为四分位数：非常低(
Background. Reports of better results at national referral centers than at low-volume community hospitals have prompted calls for regionalizing pancreaticoduodenectomy (the Whipple procedure). We examined the relationship between hospital volume and mortality with this procedure across all US hospitals.Methods. Using information form the Medicare claims database, we performed a national cohort study of 7229 Medicare patients more than 65 years old undergoing pancreaticoduodenectomy between 1992 and 1995. We divided the study population into approximate quartiles according to the hospital's average annual volume of pancreaticoduodenectomies in Medicare patients: very low (