Hospitalization outcome of heart diseases between patients who received medical care by cardiologists and non-cardiologist physicians: A propensity-score matched study

被引:4
|
作者
Wu, Yu-Ming [1 ,2 ]
Liu, Chih-Chung [2 ,3 ,4 ]
Yeh, Chun-Chieh [5 ,6 ]
Sung, Li-Chin [7 ,8 ,9 ]
Lin, Chao-Shun [2 ,3 ,4 ]
Cherng, Yih-Giun [1 ,2 ]
Chen, Ta-Liang [2 ,4 ,10 ]
Liao, Chien-Chang [2 ,3 ,4 ,11 ,12 ]
机构
[1] Taipei Med Univ, Shuang Ho Hosp, Dept Anesthesiol, New Taipei, Taiwan
[2] Taipei Med Univ, Coll Med, Sch Med, Dept Anesthesiol, Taipei, Taiwan
[3] Taipei Med Univ Hosp, Dept Anesthesiol, Taipei, Taiwan
[4] Taipei Med Univ Hosp, Anesthesiol & Hlth Policy Res Ctr, Taipei, Taiwan
[5] China Med Univ Hosp, Dept Surg, Taichung, Taiwan
[6] Univ Illinois, Dept Surg, Chicago, IL 60680 USA
[7] Taipei Med Univ, Shuang Ho Hosp, Dept Internal Med, Div Cardiol, New Taipei, Taiwan
[8] Taipei Med Univ, Sch Med, Coll Med, Div Cardiol,Dept Internal Med, Taipei, Taiwan
[9] Taipei Med Univ, Taipei Heart Inst, Taipei, Taiwan
[10] Taipei Med Univ, Wan Fang Hosp, Dept Anesthesiol, Taipei, Taiwan
[11] Taipei Med Univ, Wan Fang Hosp, Res Ctr Big Data & Metaanal, Taipei, Taiwan
[12] China Med Univ, Sch Chinese Med, Coll Chinese Med, Taichung, Taiwan
来源
PLOS ONE | 2020年 / 15卷 / 07期
关键词
ACUTE MYOCARDIAL-INFARCTION; INSURANCE RESEARCH DATABASE; FAILURE CORE MEASURES; QUALITY-OF-CARE; ELDERLY-PATIENTS; PERFORMANCE-MEASURES; CLINICAL-OUTCOMES; ISCHEMIC-STROKE; SPECIALTY; MANAGEMENT;
D O I
10.1371/journal.pone.0235207
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background and aims The effects of physician specialty on the outcome of heart disease remains incompletely understood because of inconsistent findings from some previous studies. Our purpose is to compare the admission outcomes of heart disease in patients receiving care by cardiologists and noncardiologist (NC) physicians. Methods Using reimbursement claims data of Taiwan's National Health Insurance from 2008-2013, we conducted a matched study of 6264 patients aged >= 20 years who received a cardiologist's care during admission for heart disease. Using a propensity score matching procedure adjusted for sociodemographic characteristics, medical condition, and type of heart disease, 6264 controls who received an NC physician's care were selected. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for complications and mortality during admission for heart disease associated with a cardiologist's care. Results Patients who received a cardiologist's care had a lower risk of pneumonia (OR = 0.61; 95% CI, 0.53-0.70), septicemia (OR = 0.49; 95% CI, 0.39-0.61), urinary tract infection (OR = 0.76; 95% CI, 0.66-0.88), and in-hospital mortality (OR = 0.37; 95% CI, 0.29-0.47) than did patients who received an NC physician's care. The association between a cardiologist's care and reduced adverse events following admission was significant in both sexes and in patients aged >= 40 years. Conclusion We raised the possibility that cardiologist care was associated with reduced infectious complications and mortality among patients who were admitted due to heart disease.
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页数:12
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