The Association Between Treatment Frequency and Treatment Outcome for Cardiovascular Surgeries

Korean J Thorac Cardiovasc Surg. 2016 Dec;49(Suppl 1):S20-S27. doi: 10.5090/kjtcs.2016.49.S1.S20. Epub 2016 Dec 5.

Abstract

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.

Keywords: Quality of health care; Thoracic surgery; Volume-outcome relationship.