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Postoperative adverse outcomes among physicians receiving major surgeries: A nationwide retrospective cohort study.
Medicine (Baltimore) 2016; 95(39):e4946M

Abstract

Outcomes after surgeries involving physicians as patients have not been researched. This study compares postoperative adverse events between physicians as surgical patients and nonhealth professional controls.Using reimbursement claims data from Taiwan's National Health Insurance Program, we conducted a matched retrospective cohort study of 7973 physicians as surgical patients and 7973 propensity score-matched nonphysician controls receiving in-hospital major surgeries between 2004 and 2010. We compared postoperative major complications, length of hospital stay, intensive care unit (ICU), medical expenditure, and 30-day mortality.Compared with nonphysician controls, physicians as surgical patients had lower adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of postoperative deep wound infection (OR 0.63, 95% CI 0.40-0.99; P < 0.05), prolonged length of stay (OR 0.68, 95% CI 0.62-0.75; P < 0.0001), ICU admission (OR 0.74, 95% CI 0.66-0.83; P < 0.0001), and increased medical expenditure (OR 0.80, 95% CI 0.73-0.88; P < 0.0001). Physicians as surgical patients were not associated with 30-day in-hospital mortality after surgery. Physicians working at medical centers (P < 0.05 for all), dentists (P < 0.05 for all), and those with fewer coexisting medical conditions (P < 0.05 for all) had lower risks for postoperative prolonged length of stay, ICU admission, and increased medical expenditure.Although our study's findings suggest that physicians as surgical patients have better outcomes after surgery, future clinical prospective studies are needed for validation.

Authors+Show Affiliations

aDepartment of Surgery, China Medical University Hospital, Taichung, Taiwan bSchool of Medicine, College of Medicine, China Medical University, Taichung, Taiwan cDepartment of Surgery, University of Illinois, Chicago, Illinois, USA dDepartment of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan eHealth Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan fDepartment of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan gSchool of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan hSchool of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27684836

Citation

Yeh, Chun-Chieh, et al. "Postoperative Adverse Outcomes Among Physicians Receiving Major Surgeries: a Nationwide Retrospective Cohort Study." Medicine, vol. 95, no. 39, 2016, pp. e4946.
Yeh CC, Liao CC, Shih CC, et al. Postoperative adverse outcomes among physicians receiving major surgeries: A nationwide retrospective cohort study. Medicine (Baltimore). 2016;95(39):e4946.
Yeh, C. C., Liao, C. C., Shih, C. C., Jeng, L. B., & Chen, T. L. (2016). Postoperative adverse outcomes among physicians receiving major surgeries: A nationwide retrospective cohort study. Medicine, 95(39), pp. e4946. doi:10.1097/MD.0000000000004946.
Yeh CC, et al. Postoperative Adverse Outcomes Among Physicians Receiving Major Surgeries: a Nationwide Retrospective Cohort Study. Medicine (Baltimore). 2016;95(39):e4946. PubMed PMID: 27684836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative adverse outcomes among physicians receiving major surgeries: A nationwide retrospective cohort study. AU - Yeh,Chun-Chieh, AU - Liao,Chien-Chang, AU - Shih,Chun-Chuan, AU - Jeng,Long-Bin, AU - Chen,Ta-Liang, PY - 2016/9/30/entrez PY - 2016/9/30/pubmed PY - 2017/2/18/medline SP - e4946 EP - e4946 JF - Medicine JO - Medicine (Baltimore) VL - 95 IS - 39 N2 - Outcomes after surgeries involving physicians as patients have not been researched. This study compares postoperative adverse events between physicians as surgical patients and nonhealth professional controls.Using reimbursement claims data from Taiwan's National Health Insurance Program, we conducted a matched retrospective cohort study of 7973 physicians as surgical patients and 7973 propensity score-matched nonphysician controls receiving in-hospital major surgeries between 2004 and 2010. We compared postoperative major complications, length of hospital stay, intensive care unit (ICU), medical expenditure, and 30-day mortality.Compared with nonphysician controls, physicians as surgical patients had lower adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of postoperative deep wound infection (OR 0.63, 95% CI 0.40-0.99; P < 0.05), prolonged length of stay (OR 0.68, 95% CI 0.62-0.75; P < 0.0001), ICU admission (OR 0.74, 95% CI 0.66-0.83; P < 0.0001), and increased medical expenditure (OR 0.80, 95% CI 0.73-0.88; P < 0.0001). Physicians as surgical patients were not associated with 30-day in-hospital mortality after surgery. Physicians working at medical centers (P < 0.05 for all), dentists (P < 0.05 for all), and those with fewer coexisting medical conditions (P < 0.05 for all) had lower risks for postoperative prolonged length of stay, ICU admission, and increased medical expenditure.Although our study's findings suggest that physicians as surgical patients have better outcomes after surgery, future clinical prospective studies are needed for validation. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/27684836/Postoperative_adverse_outcomes_among_physicians_receiving_major_surgeries:_A_nationwide_retrospective_cohort_study_ L2 - http://dx.doi.org/10.1097/MD.0000000000004946 DB - PRIME DP - Unbound Medicine ER -