Relationship between caseload volume and outcome for systemic lupus erythematosus treatment: The experience of Taiwan

Tzu Feng Wang, Herng Ching Lin

研究成果: 雜誌貢獻文章同行評審

8 引文 斯高帕斯(Scopus)

摘要

Objective. To determine if a physician's experience or hospital caseload volume is associated with in-hospital mortality of patients with systemic lupus erythematosus (SLE). Methods. We used data from Taiwan's National Health Insurance Research Database covering 2002 to 2004. A total of 8536 hospital admissions citing a principal diagnosis of SLE were selected. Hospitals with an average of > 50, 26-50, and <26 SLE cases per year were categorized as high, medium, and low-caseload-volume hospitals, respectively. Physician caseload volume was defined as low (> 1 SLE case per year), medium (1-3 cases per year), and high-volume (> 3 cases per year). Multivariate logistic regression analyses employing generalized estimated equations were performed to assess the independent association between physician or hospital SLE caseload volume and in-hospital mortality, after adjusting for other factors. Results. We found that in-hospital mortality declined with increasing physician caseload volume (3.0%, 1.0%, and 0.8% for low, medium, and high-volume physicians, respectively), with the adjusted odds of in-hospital mortality for patients treated by low-volume physicians being 2.681 (p <0.05) times greater than for patients treated by medium-volume physicians, and 3.195 (p <0.001) times greater than for those treated by high-volume physicians. No significant relationship was found between in-hospital mortality and hospital SLE caseload volume (p = 0.896). Conclusion. We concluded that the factor of physicians' experience treating SLE is more crucial in determining in-hospital mortality than a hospital's annual SLE caseload. The Journal of Rheumatology

原文英語
頁(從 - 到)1795-1800
頁數6
期刊Journal of Rheumatology
35
發行號9
出版狀態已發佈 - 九月 2008

ASJC Scopus subject areas

  • 風濕病
  • 免疫學
  • 免疫學和過敏

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