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Beyond volume: hospital-based healthcare technology as a predictor of mortality for cardiovascular patients in Korea

Authors
 Jae-Hyun Kim  ;  Yunhwan Lee  ;  Eun-Cheol Park 
Citation
 MEDICINE, Vol.95(24) : 3917, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adult ; Aged ; Biomedical Technology/organization & administration* ; Cardiovascular Diseases/mortality* ; Databases, Factual ; Female ; Hospital Mortality/trends ; Humans ; Male ; Middle Aged ; National Health Programs/organization & administration* ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies
Keywords
cardiovascular ; heart ; hospital ; quality ; technology
Abstract
To examine whether hospital-based healthcare technology is related to 30-day postoperative mortality rates after adjusting for hospital volume of cardiovascular surgical procedures.This study used the National Health Insurance Service-Cohort Sample Database from 2002 to 2013, which was released by the Korean National Health Insurance Service. A total of 11,109 cardiovascular surgical procedure patients were analyzed. The primary analysis was based on logistic regression models to examine our hypothesis.After adjusting for hospital volume of cardiovascular surgical procedures as well as for all other confounders, the odds ratio (OR) of 30-day mortality in low healthcare technology hospitals was 1.567-times higher (95% confidence interval [CI] = 1.069-2.297) than in those with high healthcare technology. We also found that, overall, cardiovascular surgical patients treated in low healthcare technology hospitals, regardless of the extent of cardiovascular surgical procedures, had the highest 30-day mortality rate.Although the results of our study provide scientific evidence for a hospital volume-mortality relationship in cardiovascular surgical patients, the independent effect of hospital-based healthcare technology is strong, resulting in a lower mortality rate. As hospital characteristics such as clinical pathways and protocols are likely to also play an important role in mortality, further research is required to explore their respective contributions.
Files in This Item:
T201601936.pdf Download
DOI
10.1097/MD.0000000000003917
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147008
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