title: Factors associated with delayed pediatric hypospadias surgery in Taiwan: a population-based, nationwide analysis.
abstract: OBJECTIVE
  Current guidelines recommend that hypospadias repair should be performed before age 18 months. This study aims to investigate the trends of surgical timing and to determine what factors are associated with age at surgery.
  
  
  METHODS
  The present study utilized a subset of the National Health Insurance Research Database, known as Longitudinal Health Insurance Database 2005, which contains the data of all paid medical benefit claims over the period from 1997 to 2007 for a subset of one million beneficiaries randomly drawn from the population of 22.72 million individuals in NHI program during any part of calendar year 2005. We analyzed claims data for all subjects with the diagnoses of hypospadias.
  
  
  RESULTS
  Among 52,705 live male newborns, 218 were diagnosed with hypospadias and thus were included as subjects in our study. Among them, 89 received repair surgery. Approximately 60.6% of the study subjects received repair after the age of 18 months. Multivariate analysis showed that several factors were significantly associated with age at hypospadias surgery: specialty of clinics where first diagnosis was made; specialty of physician making the first diagnosis, age of physician making the first diagnosis; specialty of surgeon performing the surgery; number of years since surgeon's board certification; urbanization level of subject's residence; modality of surgery; concomitant cryptorchidism; concomitant prematurity and low birth weight; age at diagnosis; and number of well-baby clinic visits.
  
  
  CONCLUSIONS
  This study addresses an important issue of delayed hypospadias surgery in Taiwan, which provides a potential opportunity for improvement in quality of care.
authors: Department of Nursing, Kang-Ning Junior College of Medical Care and Management, 7 Chung-Shan South Road, Taipei, Taiwan.
authors: Yu-Fen
authors: YF
authors: Chen
authors: Wei-Yi
authors: WY
authors: Huang
authors: Shyh-Chyan
authors: SC
authors: Chen
authors: Ya-Jun
authors: YJ
authors: Guo
authors: Chung-Fu
authors: CF
authors: Lan
authors: Shing-Hwa
authors: SH
authors: Liu
authors: Kuo-How
authors: KH
authors: Huang
mesh_terms: D000367:Age Factors; D001724:Birth Weight; D002983:Clinical Competence; D003456:Cryptorchidism / Q000150:complications; D013502:General Surgery / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007021:Hypospadias / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D047928:Premature Birth; D013038:Specialization / Q000706:statistics & numerical data; D013624:Taiwan; D061665:Time-to-Treatment / Q000639:trends*; D014572:Urology / Q000706:statistics & numerical data