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관상동맥우회로술(CABG)환자의 재원일수와 병원 내 사망률 변이에 대한 경피적관상동맥성형술(PTCA)과 소아심장수술(PHS)의 영향분석

A Study on the Effects of Percutaneous Transluminal Coronary Angioplasty and Pediatric Heart Surgery on the Differences of Risk-Adjusted Length of Stay and In-Hospital Death for Coronary Artery Bypass Graft Patients

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초록

The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

Abstract

The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

참고문헌 (16)

  1. 남문희, "관상동맥중재술 환자의 재원일수 중증도 보정 모형 개발", 한국콘텐츠학회 논문지, 11(9), pp.372~383 (2011), 한국콘텐츠학회
  2. "Younger patients with coronary artery disease has increased 54% in 10 years, medicalobserver" (2003)[URL]
  3. S. W. Yang, "Volume-Outcome Relationship of PTCA and CABG", pp.2008
  4. Y. D. Kwon., "Severity Measurement Methods and Comparing Hospital Death Rates for Coronary Artery Bypass Graft Surgery", Journal of Preventive Medicine and Public Health, 34(3), pp.244~252 (2001)
  5. H. G. Park., "The Case of GABG Surgery = Severity Adjusted Mortality Rates", Journal of Preventive Medicine and Public Health, 34(1), pp.21~27 (2001)
  6. 이광수, "관상동맥우회로술의 위험 수준이 병원내사망률 평가 결과에 미친 영향 분석", 보건행정학회지, 17(3), pp.87~105 (2007), 한국보건행정학회
  7. E. L. Hannan., "Pediatric Cardiac Surgery : The Effect of Hospital and Surgeon Volume on In-hospital Mortality", Pediatrics, 101(6), pp.963~969 (1998)
  8. S. K. Pansquali., "Association of Center Volume With Mortality and Complications in Pediatric Heart Surgery", Pediatric, 129(2), pp.370~376 (2012)
  9. Y. H. Kang, "Relationship between percutaneous transluminal coronary angioplasty volume and immediate outcome", pp.2000
  10. Y. J. Park, "The relationship between the characteristics of hospitals and the quality of percutaneous coronary intervention", pp.2008
  11. Inpatient Quality Indicators Development Using secondary sources, "K. S. Lee", Health Insurance Review & Assessment Service, 1~187 (2003)
  12. L. I. Lezzoni, "Risk-Adjustment for Measuring Healthcare Outcomes", international journal for quality in health care, 16(2), pp.181~182 (2004)
  13. S. K. Lee, "Comparison of the performance of comorbidity measures for predicting the mortality of patients undergoing coronary artery bypass graft surgery", pp.2009
  14. 이광수, "관상동맥우회로술 환자의 위험도에 따른 수술량과 병원내 사망의 관련성", 예방의학회지, 39(1), pp.13~20 (2006), 대한예방의학회
  15. 문경준, "중소병원의 개설 진료과목의 추세분석", 보건의료산업학회지, 6(3), pp.67~74 (2012), 보건의료산업학회

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