• Yu-Chun Chen, Mei-Jy Jeng, Yu-Sheng Lee, Yu-Cheng Lo, Pei-Chen Tsao, Chia-Feng Yang, and Wen-Jue Soong.
• Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.; Division of Respiratory Therapy, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
• J Crit Care. 2014 Dec 1;29(6):1046-51.

PurposeThe aim of this study is to examine the relationship between physician case volume and the outcomes of critically ill children with pneumonia.Materials And MethodsThis is a population-based cohort study analyzed data provided from by the National Health Insurance Research Database of Taiwan, 2006-2009. Children (aged 3 months to 17 years) having records of intensive care unit (ICU) admission and a diagnosis of pneumonia were included. A total of 9754 critically ill children and 1042 attending physicians were enrolled. The children were assigned to 1 of 4 groups based on the physician's pneumonia case volume.ResultsThe patients in the very high case volume group had a significantly lower length of hospital stay, in-hospital mortality rate, and hospitalization expenses, and a significantly higher ratio of ICU to hospital stays than the other 3 groups (P<.001). The probability of death tended to be lower when the physician's case volume was higher. The risk-adjusted odds ratio for in-hospital mortality of very-high case volume group was 0.48 (95% confidence interval, 0.35-0.65; P<.001) compared to low case volume group.ConclusionsA higher physician's pneumonia case volume is associated with a lower length of hospital stay, lower in-hospital mortality rate, and lower hospitalization expenses among critically ill children with pneumonia.Copyright © 2014 Elsevier Inc. All rights reserved.

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