The Effect of Physician Experience on Costs and Clinical Outcomes of Laparoscopic-Assisted Vaginal Hysterectomy: A Multivariate Analysis

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题名:	The Effect of Physician Experience on Costs and Clinical Outcomes of Laparoscopic-Assisted Vaginal Hysterectomy: A Multivariate Analysis
作者:	張維君(Chang,Wei-Chun)*;林正介(Lin,Cheng-Chieh);李采娟(Li,Tsai-Chung)
贡献者:	醫學院醫學系學士班婦產學科;中國附醫婦產部
日期:	2003-08
上传时间:	2009-08-20 18:50:25 (UTC+8)
摘要:	Study Objective To evaluate whether or not a physician's experience has an effect on costs and clinical outcomes of an implemented clinical pathway for laparoscopic-assisted vaginal hysterectomy (LAVH). Design Retrospective study (Canadian Task Force classification II-2). Setting University hospital. Patients One hundred twenty women. Intervention LAVHs, 84 performed by senior physicians and 36 by junior physicians. Measurements and Main Results According to results of multiple linear regression analysis, after controlling for other independent variables, senior attending physicians, each with over 6 years of experience, managed to reduce all costs related to LAVH, operating time, and length of stay. Logistic regression analysis revealed no differences in the occurrence of intravenous fluid injection, antibiotic injection more than 2 days after surgery, and complications between physicians with and those without experience. Neither group had blood transfusions, patient mortality, or readmissions within 2 weeks of discharge. Conclusion Physician experience reduces medical costs and maintains the quality of care in LAVH. We suggest regular training courses for less-experienced physicians in order to contain costs and maintain quality of care under the quota case-payment system.
關聯:	The Journal of the American Association of Gynecologic Laparoscopists 10(3):356~359
显示于类别:	[醫學系] 期刊論文

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