ArticlePloS one2021
Optimal surgeon and hospital volume thresholds to reduce mortality and length of stay for CABG.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 15 citations in OpenAlex.
- Hospital volume and efficiency in transcarotid transcatheter aortic valve replacement: Insights from a national database of 10,000+ cases.JTCVS structural and endovascular · 2026Article
- The impact of hospital volume on CT usage in the management of pediatric empyema.Pediatric surgery international · 2026Article
- Surgical Outcomes and Patient Expectations and Satisfaction in Spine Surgery Stratified by Surgeon Age.JAMA network open · 2025Article
- Cardiac Surgeons at the Start of Their Practice Have Similar Volume/Outcome Association Compared With Established Surgeons.Journal of the American Heart Association · 2025Article
- Use of computer simulation to identify effects on hospital census with reduction of transfers for non-procedural patients in community hospitals.BMJ open quality · 2024Article
- Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus.Neurocritical care · 2023Article
- Article
- Methodology in coronary artery bypass surgery quality assessment.Journal of geriatric cardiology : JGC · 2022Article
- What underlies the observed hospital volume-outcome relationship?BMC health services research · 2022Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe used nationwide population-based data to identify optimal hospital and surgeon volume thresholds and to discover the effects of these volume thresholds on operative mortality and length of stay (LOS) for coronary artery bypass surgery (CABG).
designRetrospective cohort study.
settingGeneral acute care hospitals throughout Taiwan.
participantsA total of 12,892 CABG patients admitted between 2011 and 2015 were extracted from Taiwan National Health Insurance claims data.
main outcome measuresOperative mortality and LOS. Restricted cubic splines were applied to discover the optimal hospital and surgeon volume thresholds needed to reduce operative mortality. Generalized estimating equation regression modeling, Cox proportional-hazards modeling and instrumental variables analysis were employed to examine the effects of hospital and surgeon volume thresholds on the operative mortality and LOS.
resultsThe volume thresholds for hospitals and surgeons were 55 cases and 5 cases per year, respectively. Patients who underwent CABG from hospitals that did not reach the volume threshold had higher operative mortality than those who received CABG from hospitals that did reach the volume threshold. Patients who underwent CABG with surgeons who did not reach the volume threshold had higher operative mortality and LOS than those who underwent CABG with surgeons who did reach the volume threshold.
conclusionsThis is the first study to identify the optimal hospital and surgeon volume thresholds for reducing operative mortality and LOS. This supports policies regionalizing CABG at high-volume hospitals. Identifying volume thresholds could help patients, providers, and policymakers provide optimal care.
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