Postoperative adverse outcomes among physicians receiving major surgeries: A nationwide retrospective cohort study.
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.
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.
Chun-Chieh
CC
Yeh
Chien-Chang
CC
Liao
Chun-Chuan
CC
Shih
Long-Bin
LB
Jeng
Ta-Liang
TL
Chen
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010820:Physicians / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011184:Postoperative Period; D057216:Propensity Score; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
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