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2. Contents Vol. 21, 2004

Author

Anders Thune, Lars Lundell, Albert Pey, Henrik Bergquist, Tertuliano Aires-Neto, Ana García-Agustí, Masao Hamuro, E. García-Granero, King-Teh Lee, Shungo Endo, Shoji Kubo, Y. Munz, Eryvaldo Sócrates Tabosa do Egito, Leif Nelvin, J. García-Armengol, J. Buckels, Magnus Ruth, H.W. Tilanus, Andreas Meyer, S.A. García-Botello, D. Menzies, R. Aggarwal, Wen-Tseng Chang, C. Juan, Antonio María Lacy, Hikaru Fujioka, Junzo Yamaguchi, B. Lamme, S. Lledó, M.A. Boermeester, Hasse Ejnell, Meng-Chuan Huang, Takashi Kanematsu, D. Stell, H.J.M. Oostvogel, Yasuhiro Torashima, R. de Vos, Kenji Kaneda, Salvador Morales, H.G. Gooszen, L.M.A. Akkermans, Tamio Kushihashi, H. Obertop, Yuichi Inoue, Dione Maria Valença, Kenji Nakamura, Koichi Nagata, Marek Poźniczek, Anne Blomqvist, Ingemar Fogdestam, W.E. Hueting, R.A. de Man, Moshe Hashmonai, Kunihide Izawa, O. van Ruler, Piotr Budzyński, Julio Sérgio Marchini, F. López-Mozos, A. Darzi, M.J.C. Eijkemans, Kazuhiro Hirohashi, M.C. Parker, José Luis Salvador, Matthias Behrend, Wojciech Kostarczyk, Shin-ei Kudo, Mikael Johansson, Claes Mercke, C.J.H.M. van Laarhoven, Andrzej Bobrzyński, Antonio Torres, J.W.O. van Till, C. Verhoef, Ken Taniguchi, Enrique Veloso, K. Moorthy, Angel Carrillo, Eduardo María Targarona, Hans Mark, Jerzy Krzywoń, D. Mayer, S. Undre, A. Espí, J. Hance, Xavier Feliu, Herng-Chia Chiu, Michael J. Stamos, Aldo Cunha Medeiros, Takashi Kitanosono, T. Rockall, Takatsugu Yamamoto, M.E.I. Schipper, J.N.M. IJzermans, Shigefumi Suehiro, José Brandão-Neto, Matthew R. Dixon, P.E. Zondervan, Andrzej Wysocki, Katsu Sakabe, T.J.M.V. van Vroonhoven, and D. Mirza

Subjects
Traditional medicine, business.industry, Gastroenterology, Medicine, Surgery, business
Published
2004
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3. Influence of Surgeon Volume on Clinical and Economic Outcomes of Laparoscopic Cholecystectomy

Author

Wen-Tseng Chang, Herng-Chia Chiu, King-Teh Lee, and Meng-Chuan Huang

Subjects
medicine.medical_specialty, Gallbladder disease, Taiwan, Comorbidity, Outcome Assessment, Health Care, polycyclic compounds, medicine, Humans, Laparoscopic cholecystectomy, Surgeon volume, Retrospective Studies, Medical treatment, business.industry, General surgery, Cholecystolithiasis, Gastroenterology, Length of Stay, medicine.disease, Hospital Charges, Surgery, Cholecystectomy, Laparoscopic, lipids (amino acids, peptides, and proteins), Clinical Competence, business, Surgery Department, Hospital
Abstract

Background and Purpose: The volume-outcome effect has been well documented in both medical treatment and surgery. The relationship of volume-outcome utilization in laparoscopic cholecystectomy has not been studied. The aims of this study were to examine whether the operational volume of individual surgeons is associated with the clinical and economic outcomes of patients with gallbladder diseases undergoing laparoscopic cholecystectomy. Methods: A retrospective study was made of all patients who underwent elective laparoscopic cholecystectomy in the Department of Surgery, Kaohsiung Medical University Hospital between January 1998 and April 2002. In total, 916 patients were operated on by 4 surgeons and the volume for each surgeon was 502, 192, 147, and 75 cases, respectively. Clinical and economic information for each patient was abstracted from medical charts and the financial division. Multiple logistic and linear regression models were used to examine the relationship between three outcome variables, complications, length of stay, total hospital charges, and surgeon volume while controlling for the severity of illness and other selected covariates (morbidity index). Results: Overall, a complication rate of 1.2% was identified. On average, the patient’s stay in hospital was 4.7 days, and the average total hospital charge was TWD 49,581. After adjusting for covariates, three regression models indicated that the surgeon with the highest volume had the lowest complication rate, shortest length of stay, and lowest hospital charges. Conclusions: The operative volume of individual surgeons not only had a positive impact on clinical outcomes, it also had greater effect on conservation of health care resources. The findings validate the theory of practice makes perfect.

Published
2004
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4. Subject Index Vol. 21, 2004

Author

Takashi Kitanosono, T. Rockall, Andrzej Wysocki, Takatsugu Yamamoto, Katsu Sakabe, Yuichi Inoue, W.E. Hueting, Shungo Endo, Meng-Chuan Huang, Matthew R. Dixon, P.E. Zondervan, Takashi Kanematsu, J. Buckels, Piotr Budzyński, Kazuhiro Hirohashi, Y. Munz, M.J.C. Eijkemans, M.C. Parker, Dione Maria Valença, Wojciech Kostarczyk, José Luis Salvador, Antonio María Lacy, K. Moorthy, Angel Carrillo, Wen-Tseng Chang, Mikael Johansson, T.J.M.V. van Vroonhoven, M.A. Boermeester, F. López-Mozos, A. Darzi, R. de Vos, Magnus Ruth, Eduardo María Targarona, H.W. Tilanus, S. Lledó, J. Hance, Herng-Chia Chiu, Eryvaldo Sócrates Tabosa do Egito, Julio Sérgio Marchini, Koichi Nagata, R. Aggarwal, D. Mirza, C.J.H.M. van Laarhoven, Hasse Ejnell, J. García-Armengol, S.A. García-Botello, Tamio Kushihashi, Matthias Behrend, Xavier Feliu, E. García-Granero, R.A. de Man, Claes Mercke, Salvador Morales, H.J.M. Oostvogel, H. Obertop, Hans Mark, José Brandão-Neto, Albert Pey, Kenji Kaneda, Junzo Yamaguchi, Ana García-Agustí, Masao Hamuro, Anne Blomqvist, H.G. Gooszen, Ingemar Fogdestam, King-Teh Lee, L.M.A. Akkermans, C. Juan, Andrzej Bobrzyński, Marek Poźniczek, Shigefumi Suehiro, O. van Ruler, Leif Nelvin, B. Lamme, Shin-ei Kudo, Antonio Torres, J.W.O. van Till, Ken Taniguchi, S. Undre, M.E.I. Schipper, Kunihide Izawa, J.N.M. IJzermans, Moshe Hashmonai, Tertuliano Aires-Neto, Shoji Kubo, Anders Thune, Lars Lundell, Henrik Bergquist, Yasuhiro Torashima, Enrique Veloso, D. Mayer, Andreas Meyer, D. Menzies, Hikaru Fujioka, D. Stell, Kenji Nakamura, Michael J. Stamos, Aldo Cunha Medeiros, C. Verhoef, Jerzy Krzywoń, and A. Espí

Subjects
Index (economics), business.industry, Statistics, Gastroenterology, Medicine, Surgery, Subject (documents), business
Published
2004
Full Text
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5. Influence of Surgeon Volume on Clinical and Economic Outcomes of Laparoscopic Cholecystectomy.

Author

King-Teh Lee, Wen-Tseng Chang, Meng-Chuan Huang, and Herng-Chia Chiu

Subjects
*CHOLECYSTECTOMY, *GALLBLADDER surgery, *GALLBLADDER diseases, *SURGEONS, *HOSPITAL charges
Abstract

Background and Purpose: The volume-outcome effect has been well documented in both medical treatment and surgery. The relationship of volume-outcome utilization in laparoscopic cholecystectomy has not been studied. The aims of this study were to examine whether the operational volume of individual surgeons is associated with the clinical and economic outcomes of patients with gallbladder diseases undergoing laparoscopic cholecystectomy. Methods: A retrospective study was made of all patients who underwent elective laparoscopic cholecystectomy in the Department of Surgery, Kaohsiung Medical University Hospital between January 1998 and April 2002. In total, 916 patients were operated on by 4 surgeons and the volume for each surgeon was 502, 192, 147, and 75 cases, respectively. Clinical and economic information for each patient was abstracted from medical charts and the financial division. Multiple logistic and linear regression models were used to examine the relationship between three outcome variables, complications, length of stay, total hospital charges, and surgeon volume while controlling for the severity of illness and other selected covariates (morbidity index). Results: Overall, a complication rate of 1.2% was identified. On average, the patient's stay in hospital was 4.7 days, and the average total hospital charge was TWD 49,581 . After adjusting for covariates, three regression models indicated that the surgeon with the highest volume had the lowest complication rate, shortest length of stay, and lowest hospital charges. Conclusions: The operative volume of individual surgeons not only had a positive impact on clinical outcomes, it also had greater effect on conservation of health care resources. The findings validate the theory of practice makes perfect. [ABSTRACT FROM AUTHOR]

Published
2004
Full Text
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