林恆慶Lin HCLee HC2026-05-252026-05-252008https://203.71.86.71/handle/123456789/37290Summary. Objective: This study sets out to examine the &#13;association between physician and hospital pulmonary embolism &#13;(PE) caseload volume and subsequent patient outcomes &#13;using 3-year nationwide population-based data in Taiwan. &#13;Method: This study used claims data from the 2002–2004 &#13;National Health Insurance Research Database. The sample of &#13;2761 PE inpatients was divided into three physician caseload &#13;volume groups, <3 cases (low volume), 3–6 cases (medium &#13;volume) and ‡7 cases (high volume), while the three hospital &#13;volume groups were <42 cases (low volume), 42–110 cases &#13;(medium volume) and ‡111 cases (high volume). A conditional &#13;logistic regression model was performed to evaluate the effects &#13;of caseload volume on 30-day mortality for PE treatment. &#13;Results: Patients treated by low case volume physicians had &#13;significantly higher mortality rates than those treated by &#13;medium case volume (19.0% vs. 13.3%, P < 0.001) or high &#13;case volume physicians (19.0% vs. 8.4%, P < 0.001). However, &#13;no significant relationship was observed between 30-day &#13;morality and hospital caseload volume (P = 0.697). The &#13;regression shows that the adjusted odds of 30-day mortality &#13;among patients of low case volume physicians were over twice &#13;the mortality odds among patients of high case volume &#13;physicians (OR = 2.164, P < 0.001), and odds ratios were &#13;1.401 relative to medium case volume physicians patients &#13;(P < 0.05). Conclusion: We conclude that an inverse PE &#13;volume-outcome relationship does exist for physicians, but not &#13;for hospitals. The skill or experience of an individual physician &#13;is a more critical factor than hospital equipment, infrastructure &#13;or staffing team in determining PE patient outcomes. &#13;Keywords: 30-day mortality, pulmonary embolism, volumeoutcome.en-US醫務管理學系期刊論文Volume-Outcome Relation for Pulmonary Embolism Treatment: Association between Physician and Hospital Volume and 30-day Mortalityarticle