Hospital case volume and clinical outcomes for peptic ulcer treatment.

  • Lou H
  • Lin H
  • Chen K
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Abstract

No study has explored the volume-outcome relationship for peptic ulcer treatment.To investigate the association between peptic ulcer case volume per hospital, on the one hand, and in-hospital mortality and 14-day readmission rates, on the other, using a nationwide population-based dataset.A retrospective cross-sectional study, set in Taiwan.There were 48,250 peptic ulcer patients included. Each patient was assigned to one of three hospital volume groups: low-volume (< or = 189 case), medium volume (190-410 cases), and high volume (> or = 411 cases).Logistic regression analysis employing generalized estimating equations was used to examine the adjusted relationship of hospital volume with in-hospital mortality and 14-day readmission.After adjusting for other factors, results showed that the likelihood of in-hospital mortality for peptic ulcer patients treated by low-volume hospitals (mortality rate = 0.68 was 1.6 times (p < 0.05) that of those treated in high-volume hospitals (mortality rate = 0.72 and 1.4 times (p < 0.05) that of those treated in medium-volume hospitals (mortality rate = 0.73. The adjusted odds ratio of 14-day readmission likewise declined with increasing hospital volume, with the odds of 14-day readmission for those patients treated by low-volume hospitals being 1.5 times (p < 0.001) greater than for high-volume hospitals and 1.3 times (p < 0.01) greater than for medium-volume hospitals.We found that, after adjusting for other factors, peptic ulcer patients treated in the low-volume hospitals had inferior clinical outcomes compared to those treated in medium-volume or high-volume ones.

Author-supplied keywords

  • Aged; Cross-Sectional Studies; Databases
  • Factual; Female; Hospital Mortality; Hospitalizati
  • diagnosis/epidemiology/therapy; Retrospective Stud
  • methods; Peptic Ulcer

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Authors

  • Horng-Yuan Lou

  • Herng-Ching Lin

  • Kuan-Yang Chen

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