Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction
CONTEXT Acute myocardial infarction (AMI) is a common condition that is treated by physicians with varying levels of clinical experience, but whether the level of experience affects outcome remains uncertain. OBJECTIVE To evaluate the relationship between the average annual volume of cases treated b...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2001-06, Vol.285 (24), p.3116-3122 |
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| creator | Tu, Jack V Austin, Peter C Chan, Benjamin T. B |
| description | CONTEXT Acute myocardial infarction (AMI) is a common condition that is treated
by physicians with varying levels of clinical experience, but whether the
level of experience affects outcome remains uncertain. OBJECTIVE To evaluate the relationship between the average annual volume of cases
treated by admitting physicians and mortality after AMI. DESIGN, SETTING, AND PATIENTS Retrospective cohort study using linked administrative databases containing
patient admission information for 98 194 patients treated by 5374 physicians
between April 1, 1992, and March 31, 1998, in Ontario, Canada. MAIN OUTCOME MEASURES Mortality risk rates for 30 days and 1 year post-AMI, adjusted by physician
volume and patient, physician, and hospital characteristics. RESULTS The 30-day mortality rate was 13.5% and the 1-year mortality rate was
21.8%. A strong inverse relationship between the average annual volume of
AMI cases treated by the admitting physician and mortality after an AMI was
observed. The 30-day risk-adjusted mortality rate was 15.3% for physicians
who treated 5 or fewer AMI cases per year (lowest quartile) compared with
11.8% for physicians who treated more than 24 AMI cases annually (highest
quartile; P |
| doi_str_mv | 10.1001/jama.285.24.3116 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_70973669</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>193956</ama_id><sourcerecordid>74782557</sourcerecordid><originalsourceid>FETCH-LOGICAL-a436t-d387d545281bf8fe8d165fd507cbb1ea0933ce6a4a0beadf15c76c5f57b1d3b43</originalsourceid><addsrcrecordid>eNpd0UFrFTEQAOAgFvtavetFghRv-0w2m2T3-CxVCy0WqV6X2WRi89jNviZZyjv0vxvpk4JzmcN8zAwzhLzlbM0Z45-2MMG6buW6btaCc_WCrLgUbSVk174kK8a6ttJN2xyTk5S2rAQX-hU55rypNW_Yijz-wBGyn0O68zv6GfMDYqCbEBYY6a95XCaks6M3xWDIid5GhIyWDnu6sZPP2Yff9OZun7zxECgES6_nmGH0uQiXMdKNWTLS6_1sIFpf2l4GB9H8HfqaHDkYE7455FPy88vF7fm36ur718vzzVUFjVC5sqLVVjaybvngWoet5Uo6K5k2w8ARWCeEQQUNsAHBOi6NVkY6qQduxdCIU_Lxqe8uzvcLptxPPhkcRwg4L6nXrNNCqa7AD__B7bzEUHbra86F0uWaBb0_oGWY0Pa76CeI-_7fVQs4OwBIBkYXIRifnh0TnVC8sHdPrHzxudiJTirxB3fnkHg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211367748</pqid></control><display><type>article</type><title>Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Tu, Jack V ; Austin, Peter C ; Chan, Benjamin T. B</creator><creatorcontrib>Tu, Jack V ; Austin, Peter C ; Chan, Benjamin T. B</creatorcontrib><description>CONTEXT Acute myocardial infarction (AMI) is a common condition that is treated
by physicians with varying levels of clinical experience, but whether the
level of experience affects outcome remains uncertain. OBJECTIVE To evaluate the relationship between the average annual volume of cases
treated by admitting physicians and mortality after AMI. DESIGN, SETTING, AND PATIENTS Retrospective cohort study using linked administrative databases containing
patient admission information for 98 194 patients treated by 5374 physicians
between April 1, 1992, and March 31, 1998, in Ontario, Canada. MAIN OUTCOME MEASURES Mortality risk rates for 30 days and 1 year post-AMI, adjusted by physician
volume and patient, physician, and hospital characteristics. RESULTS The 30-day mortality rate was 13.5% and the 1-year mortality rate was
21.8%. A strong inverse relationship between the average annual volume of
AMI cases treated by the admitting physician and mortality after an AMI was
observed. The 30-day risk-adjusted mortality rate was 15.3% for physicians
who treated 5 or fewer AMI cases per year (lowest quartile) compared with
11.8% for physicians who treated more than 24 AMI cases annually (highest
quartile; P<.001). The 1-year risk-adjusted mortality
rate was 24.2% for physicians who treated 5 or fewer AMI cases per year (lowest
quartile) compared with 19.6% for physicians who treated more than 24 AMI
cases annually (highest quartile; P<.001). CONCLUSION Patients with AMI who are treated by high-volume admitting physicians
are more likely to survive at 30 days and 1 year.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.285.24.3116</identifier><identifier>PMID: 11427140</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Aged ; Biological and medical sciences ; Cardiology - statistics & numerical data ; Cardiology. Vascular system ; Cohort Studies ; Coronary heart disease ; Family Practice - statistics & numerical data ; Heart ; Heart attacks ; Hospitalization ; Hospitalization - statistics & numerical data ; Hospitals - statistics & numerical data ; Humans ; Internal Medicine - statistics & numerical data ; Logistic Models ; Medical sciences ; Mortality ; Myocardial Infarction - classification ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Ontario - epidemiology ; Outcome and Process Assessment (Health Care) ; Physician patient relationships ; Retrospective Studies</subject><ispartof>JAMA : the journal of the American Medical Association, 2001-06, Vol.285 (24), p.3116-3122</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright American Medical Association Jun 27, 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a436t-d387d545281bf8fe8d165fd507cbb1ea0933ce6a4a0beadf15c76c5f57b1d3b43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.285.24.3116$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.285.24.3116$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76231,76234</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1039361$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11427140$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tu, Jack V</creatorcontrib><creatorcontrib>Austin, Peter C</creatorcontrib><creatorcontrib>Chan, Benjamin T. B</creatorcontrib><title>Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Acute myocardial infarction (AMI) is a common condition that is treated
by physicians with varying levels of clinical experience, but whether the
level of experience affects outcome remains uncertain. OBJECTIVE To evaluate the relationship between the average annual volume of cases
treated by admitting physicians and mortality after AMI. DESIGN, SETTING, AND PATIENTS Retrospective cohort study using linked administrative databases containing
patient admission information for 98 194 patients treated by 5374 physicians
between April 1, 1992, and March 31, 1998, in Ontario, Canada. MAIN OUTCOME MEASURES Mortality risk rates for 30 days and 1 year post-AMI, adjusted by physician
volume and patient, physician, and hospital characteristics. RESULTS The 30-day mortality rate was 13.5% and the 1-year mortality rate was
21.8%. A strong inverse relationship between the average annual volume of
AMI cases treated by the admitting physician and mortality after an AMI was
observed. The 30-day risk-adjusted mortality rate was 15.3% for physicians
who treated 5 or fewer AMI cases per year (lowest quartile) compared with
11.8% for physicians who treated more than 24 AMI cases annually (highest
quartile; P<.001). The 1-year risk-adjusted mortality
rate was 24.2% for physicians who treated 5 or fewer AMI cases per year (lowest
quartile) compared with 19.6% for physicians who treated more than 24 AMI
cases annually (highest quartile; P<.001). CONCLUSION Patients with AMI who are treated by high-volume admitting physicians
are more likely to survive at 30 days and 1 year.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology - statistics & numerical data</subject><subject>Cardiology. Vascular system</subject><subject>Cohort Studies</subject><subject>Coronary heart disease</subject><subject>Family Practice - statistics & numerical data</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals - statistics & numerical data</subject><subject>Humans</subject><subject>Internal Medicine - statistics & numerical data</subject><subject>Logistic Models</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Myocardial Infarction - classification</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Ontario - epidemiology</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Physician patient relationships</subject><subject>Retrospective Studies</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0UFrFTEQAOAgFvtavetFghRv-0w2m2T3-CxVCy0WqV6X2WRi89jNviZZyjv0vxvpk4JzmcN8zAwzhLzlbM0Z45-2MMG6buW6btaCc_WCrLgUbSVk174kK8a6ttJN2xyTk5S2rAQX-hU55rypNW_Yijz-wBGyn0O68zv6GfMDYqCbEBYY6a95XCaks6M3xWDIid5GhIyWDnu6sZPP2Yff9OZun7zxECgES6_nmGH0uQiXMdKNWTLS6_1sIFpf2l4GB9H8HfqaHDkYE7455FPy88vF7fm36ur718vzzVUFjVC5sqLVVjaybvngWoet5Uo6K5k2w8ARWCeEQQUNsAHBOi6NVkY6qQduxdCIU_Lxqe8uzvcLptxPPhkcRwg4L6nXrNNCqa7AD__B7bzEUHbra86F0uWaBb0_oGWY0Pa76CeI-_7fVQs4OwBIBkYXIRifnh0TnVC8sHdPrHzxudiJTirxB3fnkHg</recordid><startdate>20010627</startdate><enddate>20010627</enddate><creator>Tu, Jack V</creator><creator>Austin, Peter C</creator><creator>Chan, Benjamin T. B</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20010627</creationdate><title>Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction</title><author>Tu, Jack V ; Austin, Peter C ; Chan, Benjamin T. B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a436t-d387d545281bf8fe8d165fd507cbb1ea0933ce6a4a0beadf15c76c5f57b1d3b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology - statistics & numerical data</topic><topic>Cardiology. Vascular system</topic><topic>Cohort Studies</topic><topic>Coronary heart disease</topic><topic>Family Practice - statistics & numerical data</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Hospitalization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals - statistics & numerical data</topic><topic>Humans</topic><topic>Internal Medicine - statistics & numerical data</topic><topic>Logistic Models</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Myocardial Infarction - classification</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Ontario - epidemiology</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Physician patient relationships</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tu, Jack V</creatorcontrib><creatorcontrib>Austin, Peter C</creatorcontrib><creatorcontrib>Chan, Benjamin T. B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tu, Jack V</au><au>Austin, Peter C</au><au>Chan, Benjamin T. B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2001-06-27</date><risdate>2001</risdate><volume>285</volume><issue>24</issue><spage>3116</spage><epage>3122</epage><pages>3116-3122</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Acute myocardial infarction (AMI) is a common condition that is treated
by physicians with varying levels of clinical experience, but whether the
level of experience affects outcome remains uncertain. OBJECTIVE To evaluate the relationship between the average annual volume of cases
treated by admitting physicians and mortality after AMI. DESIGN, SETTING, AND PATIENTS Retrospective cohort study using linked administrative databases containing
patient admission information for 98 194 patients treated by 5374 physicians
between April 1, 1992, and March 31, 1998, in Ontario, Canada. MAIN OUTCOME MEASURES Mortality risk rates for 30 days and 1 year post-AMI, adjusted by physician
volume and patient, physician, and hospital characteristics. RESULTS The 30-day mortality rate was 13.5% and the 1-year mortality rate was
21.8%. A strong inverse relationship between the average annual volume of
AMI cases treated by the admitting physician and mortality after an AMI was
observed. The 30-day risk-adjusted mortality rate was 15.3% for physicians
who treated 5 or fewer AMI cases per year (lowest quartile) compared with
11.8% for physicians who treated more than 24 AMI cases annually (highest
quartile; P<.001). The 1-year risk-adjusted mortality
rate was 24.2% for physicians who treated 5 or fewer AMI cases per year (lowest
quartile) compared with 19.6% for physicians who treated more than 24 AMI
cases annually (highest quartile; P<.001). CONCLUSION Patients with AMI who are treated by high-volume admitting physicians
are more likely to survive at 30 days and 1 year.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>11427140</pmid><doi>10.1001/jama.285.24.3116</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | JAMA : the journal of the American Medical Association, 2001-06, Vol.285 (24), p.3116-3122 |
| issn | 0098-7484 1538-3598 |
| language | eng |
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| source | MEDLINE; American Medical Association Journals |
| subjects | Aged Biological and medical sciences Cardiology - statistics & numerical data Cardiology. Vascular system Cohort Studies Coronary heart disease Family Practice - statistics & numerical data Heart Heart attacks Hospitalization Hospitalization - statistics & numerical data Hospitals - statistics & numerical data Humans Internal Medicine - statistics & numerical data Logistic Models Medical sciences Mortality Myocardial Infarction - classification Myocardial Infarction - mortality Myocardial Infarction - therapy Ontario - epidemiology Outcome and Process Assessment (Health Care) Physician patient relationships Retrospective Studies |
| title | Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction |
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