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Volume-Outcome Relation for Acute Appendicitis: Evidence from a Nationwide Population-Based Study

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  • Po-Li Wei
  • Shih-Ping Liu
  • Joseph J Keller
  • Herng-Ching Lin

Abstract

Background: Although procedures like appendectomy have been studied extensively, the relative importance of each surgeon's surgical volume-to-ruptured appendicitis has not been explored. The purpose of this study was to investigate the rate of ruptured appendicitis by surgeon-volume groups as a measure of quality of care for appendicitis by using a nationwide population-based dataset. Methods: We identified 65,339 first-time hospitalizations with a discharge diagnosis of acute appendicitis (International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes 540, 540.0, 540.1 and 540.9) between January 2007 and December 2009. We used “whether or not a patient had a perforated appendicitis” as the outcome measure. A conditional (fixed-effect) logistic regression model was performed to explore the odds of perforated appendicitis among surgeon case volume groups. Results: Patients treated by low-volume surgeons had significantly higher morbidity rates than those treated by high-volume (28.1% vs. 26.15, p

Suggested Citation

  • Po-Li Wei & Shih-Ping Liu & Joseph J Keller & Herng-Ching Lin, 2012. "Volume-Outcome Relation for Acute Appendicitis: Evidence from a Nationwide Population-Based Study," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-5, December.
    • Handle: RePEc:plo:pone00:0052539
    DOI: 10.1371/journal.pone.0052539
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    Cited by:

    1. Woohyeon Kim & Stephen Wolff & Vivian Ho, 2016. "Measuring the Volume-Outcome Relation for Complex Hospital Surgery," Applied Health Economics and Health Policy, Springer, vol. 14(4), pages 453-464, August.

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