종합병원 암 종별 수술량이 병원 내 사망에 미치는 영향

Abstract

Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The pur-pose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy de-velopment in reducing cancer mortality.Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period be-tween 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators.Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer ex-cept for pancreatic cancer.Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by se-lecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.Keywords: Surgery volume; Cancer mortality; Discharge summary data