title: Association of Physician Certification Policy and Quality of Care: Evidence of percutaneous coronary intervention certification program in Taiwan.
abstract: OBJECTIVE
  The aim of this study was to compare procedural, short-term and two-year outcomes of percutaneous coronary intervention (PCI) between board-certified and non-board certified interventional cardiologists in Taiwan.
  
  
  BACKGROUND
  Most studies of associations between quality and certification have analyzed populations in the Western developed countries.
  
  
  METHODS
  This retrospective population-based study analyzed 2057 patients who had received PCI in 11 hospitals in 2007. The outcome measures were procedural, 30-day, and 2-year adverse events.
  
  
  RESULTS
  Sixty certified physicians performed 1771 PCI procedures whereas 84 non-certified physicians performed 286 procedures. Patients treated by non-certified physicians had significantly higher rates of in-hospital mortality (6.99% vs. 2.82%, respectively; p ≤ 0.001) and same-stay CABG (1.40% vs. 0.06%, respectively; p ≤ 0.001). The results of multilevel logistic regression and Cox multivariate regression indicated that patients treated by non-certified physicians also had higher probabilities of in-hospital death (OR=2.92, 95% CI: 1.20-7.08) and two-year death (hazard ratio, 1.63; 95% confidence interval, 1.18-2.24).
  
  
  CONCLUSIONS
  This is the first study in Asia in investigating the association between board certification policy and surgical outcomes, and the results confirmed that the board certification policy is also effective for Asian population. The policy implications of these findings are discussed.
authors: Bureau of National Health Insurance, Department of Health, Executive Yuan, Taiwan.
authors: Shu-Hui
authors: SH
authors: Kao
authors: Pingtung Hospital Executive Yuan, Department of Health, Taiwan.
authors: Dau-Kuan
authors: DK
authors: Lu
authors: College of Health and Public Affairs, University of Central Florida, Orlando, FL, USA.
authors: Yi-Ling
authors: YL
authors: Lin
authors: Department of Public Health, Kaohsiung Medical University, Taiwan.
authors: Hui-Min
authors: HM
authors: Hsieh
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan; School of Medicine, Kaohsiung Medical University, Taiwan.
authors: Tsung-Hsien
authors: TH
authors: Lin
authors: Department of Healthcare Administration and Health Informatics, College of Allied Health, Kaohsiung Medical University Kaohsiung, Taiwan; Department of Business Administration, National Sun Yat-Sen University, Taiwan. Electronic address: chiu@kmu.edu.tw.
authors: Herng-Chia
authors: HC
authors: Chiu
mesh_terms: D000368:Aged; D002568:Certification / Q000458:organization & administration*; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072896:Morgue; D062645:Percutaneous Coronary Intervention / Q000401:mortality / Q000592:standards*; D010820:Physicians / Q000458:organization & administration / Q000592:standards; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D013624:Taiwan
keywords: Certification program; Certified interventional cardiologist; Clinical outcome; Percutaneous coronary intervention