The Association Between Treatment Frequency and Treatment Outcome for Cardiovascular Surgeries

Background This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

[1]  J. Choi,et al.  Risk Factors of Red Blood Cell Transfusion in Isolate off Pump Coronary Artery Bypass Surgery , 2012, The Korean journal of thoracic and cardiovascular surgery.

[2]  S. Choo,et al.  Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality , 2011, The Korean journal of thoracic and cardiovascular surgery.

[3]  P. Post,et al.  The relation between volume and outcome of coronary interventions: a systematic review and meta-analysis. , 2010, European heart journal.

[4]  H. Selker,et al.  Volume-outcome relationship for coronary artery bypass grafting in an era of decreasing volume. , 2008, Archives of surgery.

[5]  Herng‐Ching Lin,et al.  Volume-outcome relationships in coronary artery bypass graft surgery patients: 5-year major cardiovascular event outcomes. , 2008, The Journal of thoracic and cardiovascular surgery.

[6]  K. Eagle,et al.  Should coronary artery bypass grafting be regionalized? , 2005, The Annals of thoracic surgery.

[7]  E. DeLong,et al.  Procedural volume as a marker of quality for CABG surgery. , 2004, JAMA.

[8]  H. Krumholz,et al.  Hospital Coronary Artery Bypass Graft Surgery Volume and Patient Mortality, 1998–2000 , 2004, Annals of surgery.

[9]  M. Chassin,et al.  Achieving and sustaining improved quality: lessons from New York State and cardiac surgery. , 2002, Health affairs.

[10]  Y. Khang,et al.  Relationship between Percutaneous Transluminal Coronary Angioplasty Volume and Associated Immediate Outcome , 2001 .

[11]  E L Hannan,et al.  Coronary Artery Bypass Surgery: The Relationship Between Inhospital Mortality Rate and Surgical Volume After Controlling For Clinical Risk Factors , 1991, Medical care.

[12]  Sang-il Lee,et al.  [Does a higher coronary artery bypass graft surgery volume always have a low in-hospital mortality rate in Korea?]. , 2006, Journal of preventive medicine and public health = Yebang Uihakhoe chi.