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頁籤選單縮合
題名 | 醫院、醫師手術量與肝癌病人術後死亡率之關係=The Relationship between Hospital, Physician Volume and In-Hospital Mortality for Patients with Hepatocellular Carcinoma |
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作 者 | 呂庭輝; 楊長興; 黃昱瞳; 林明慧; | 書刊名 | 澄清醫護管理雜誌 |
卷期 | 3:1 2007.01[民96.01] |
頁次 | 頁46-51 |
分類號 | 419.47 |
關鍵詞 | 醫院手術量; 醫師手術量; 醫師年資; 肝癌; 術後死亡率; Hospital volume; Physician volume; Hepatocellular carcinoma; In-hospital mortality; |
語文 | 中文(Chinese) |
中文摘要 | 目標:探討醫院、醫師手術量與肝癌病人術後死 亡率之相關性。 方法:採橫斷性研究,以1999年至2001年健保住 院資料中肝瘋手術病人為研究對象,採用 描述性分析及邏輯斯回歸,分析醫院、醫 師手術量與病人術後死亡率之關係。 結果:控制病人及醫院特性後,醫院的手術量 或是醫師的手術量越大,病人術後死亡 的危險性越低(OR=0.68,P<O.OOl; OR=.的, P<O.OOl) ,而同時考量醫院的手術量與醬 師的手術量後,由手術量大的醫師治療的 病人,術後死亡的危險性越低(OR=O.衍, .P<O.OOl) ,但醫院手術量的大小與病人的 死亡率無關(OR=0.93,P=0.53)。 結論:醫師個人的手術量的多寡比醫院整體的手 術量更能解釋肝癌病人術後死亡的危險 性,建議主管機關公開醫院及醫師醫療照 護品質之結果,以作為氏眾選擇醫院之參 考依據,此外,深入研究與好的照護結果 相關的行為或指標,並推廣至其他的醫院 或醫師,使病人能有更好的照護結果。 |
英文摘要 | Objectives To examine whether there is an association between hospital, physician volume and in-hospital mortality for patients with hepatocellular carcinoma(HCC). Methods : A cross-sectional research design was adopted. Data set was obtained from the National Health Research Institute, which is a three-year (1999-2001)claimed data on the National Health Insurance. Patients who underwent liver cancer resectïons were usedfor analysis. Lθgistic regression was employed for examining the relationship between hospital, physician volume and operative mortality for patients with HCC. Results Physician volume was inversely related to in-hospital mortality for patients with HCC(OR=0.65, P<O.OO1). Conclusions : Physician volume is a more important factor for in-hospital mortality for patients with HCC than hospital volume. Health report card concerning the outcome of care for HCC patients may be necessaηfor guiding the search for more cost-effectiveness and safer care. |
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