Optimal surgeon and hospital volume thresholds to reduce mortality and length of stay for CABG.

摘要: Objective We used nationwide population-based data to identify optimal hospital and surgeon volume thresholds discover the effects of these on operative mortality length stay (LOS) for coronary artery bypass surgery (CABG). Design Retrospective cohort study. Setting General acute care hospitals throughout Taiwan. Participants A total 12,892 CABG patients admitted between 2011 2015 were extracted from Taiwan National Health Insurance claims data. Main outcome measures Operative LOS. Restricted cubic splines applied needed reduce mortality. Generalized estimating equation regression modeling, Cox proportional-hazards modeling instrumental variables analysis employed examine Results The surgeons 55 cases 5 per year, respectively. Patients who underwent that did not reach threshold had higher than those received threshold. with LOS Conclusions This is first study reducing supports policies regionalizing at high-volume hospitals. Identifying could help patients, providers, policymakers provide care.