1. NCCU Academic Hub
  2. 學術產出
  3. College of Social Science
  4. Periodical Articles
  5. Item

學術產出-Periodical Articles

Article View/Open

Publication Export

Google ScholarTM

政大圖書館

Citation Infomation

  • No doi shows Citation Infomation
題名 Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneity
作者 Hockenberry JM;Lien, HM;Chou, SY
貢獻者 政大財政系
日期 2010-10
上傳時間 26-Aug-2013 16:10:39 (UTC+8)
摘要 Objective. To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Data Sources/ Study Setting. Multiple sources of linked data from the National Health Insurance Program in Taiwan. Study Design. The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. GEE and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Principal Findings. Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1, 3, 6 and 12 month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Conclusions. Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume-outcome relationship, and after accounting for it surgeon volume effects on short term mortality are large. Employing models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume.
關聯 Health Service Research, 45(5), 1168-1187
資料類型 article
dc.contributor 政大財政系en_US
dc.creator (作者) Hockenberry JM;Lien, HM;Chou, SYen_US
dc.date (日期) 2010-10en_US
dc.date.accessioned 26-Aug-2013 16:10:39 (UTC+8)-
dc.date.available 26-Aug-2013 16:10:39 (UTC+8)-
dc.date.issued (上傳時間) 26-Aug-2013 16:10:39 (UTC+8)-
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/59144-
dc.description.abstract (摘要) Objective. To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Data Sources/ Study Setting. Multiple sources of linked data from the National Health Insurance Program in Taiwan. Study Design. The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. GEE and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Principal Findings. Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1, 3, 6 and 12 month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Conclusions. Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume-outcome relationship, and after accounting for it surgeon volume effects on short term mortality are large. Employing models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume.en_US
dc.language.iso en_US-
dc.relation (關聯) Health Service Research, 45(5), 1168-1187en_US
dc.title (題名) Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneityen_US
dc.type (資料類型) articleen