Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan

Objective: Using a population-based nationwide database, we describe the changing surgical trends for laparoscopy or laparotomy for benign ovarian tumors among hospitals of different accreditation levels in Taiwan (medical centers, regional hospitals, and local hospitals). Materials and methods: Wom...

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Main Authors: Ming-Ping Wu, Chia-Jen Wu, Cheng-Yu Long, Chung-Han Ho, Kuan-Hui Huang, Chin-Chen Chu, Cheng-Yang Chou
Format: Article
Language:English
Published: Elsevier 2013-12-01
Series:Taiwanese Journal of Obstetrics & Gynecology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S102845591300171X
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author Ming-Ping Wu
Chia-Jen Wu
Cheng-Yu Long
Chung-Han Ho
Kuan-Hui Huang
Chin-Chen Chu
Cheng-Yang Chou
author_facet Ming-Ping Wu
Chia-Jen Wu
Cheng-Yu Long
Chung-Han Ho
Kuan-Hui Huang
Chin-Chen Chu
Cheng-Yang Chou
author_sort Ming-Ping Wu
collection DOAJ
description Objective: Using a population-based nationwide database, we describe the changing surgical trends for laparoscopy or laparotomy for benign ovarian tumors among hospitals of different accreditation levels in Taiwan (medical centers, regional hospitals, and local hospitals). Materials and methods: Women who had National Health Insurance and received either laparoscopy or laparotomy as the primary surgery for benign ovarian tumors in Taiwan during 1999–2009 were identified for analysis. Results: In total, 135,793 women who received either laparotomic (39,779) or laparoscopic surgery (96,014) for benign ovarian pathology were identified. The increase in annual laparoscopy number from 7176 in 1999 to 11,046 in 2009 was significant according to a log-linear regression test (p < 0.0001). The decrease in laparotomies from 3845 to 3567 was not significant (p = 0.190). Service volume shifts from local hospitals to regional hospitals were noted, with a concomitant decrease in the numbers of local hospitals. Laparoscopy was used more often than laparotomy among all three hospital accreditation levels. An increasing trend for choosing laparoscopy was observed for medical centers and local hospitals (p < 0.0001), but not regional hospitals (p = 0.0745). Laparoscopy was used more often in younger patients, by younger surgeons, and by male surgeons among hospitals at all three accreditation levels. Conclusion: Laparoscopy was preferentially used over laparotomy at all three hospital levels. An increasing trend for choosing laparoscopy was observed for medical centers and local hospitals, but not regional hospitals. Service volume shifts from local hospitals to regional hospitals were noted. Use of laparoscopy differed according to patient age, surgeon age, and surgeon gender among different hospital levels.
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spelling doaj.art-0655e374be4f4b3bb68b3b50882afe8b2022-12-21T22:09:15ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592013-12-0152449850410.1016/j.tjog.2013.10.008Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in TaiwanMing-Ping Wu0Chia-Jen Wu1Cheng-Yu Long2Chung-Han Ho3Kuan-Hui Huang4Chin-Chen Chu5Cheng-Yang Chou6Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chia-Yi Medical Center, Chiayi, TaiwanObstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Gynecology, Department of Medical Research, Chi Mei Medical Center, Tainan, TaiwanDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Anesthesiology, Chi Mei Foundation Hospital, Tainan, TaiwanDepartment of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, TaiwanObjective: Using a population-based nationwide database, we describe the changing surgical trends for laparoscopy or laparotomy for benign ovarian tumors among hospitals of different accreditation levels in Taiwan (medical centers, regional hospitals, and local hospitals). Materials and methods: Women who had National Health Insurance and received either laparoscopy or laparotomy as the primary surgery for benign ovarian tumors in Taiwan during 1999–2009 were identified for analysis. Results: In total, 135,793 women who received either laparotomic (39,779) or laparoscopic surgery (96,014) for benign ovarian pathology were identified. The increase in annual laparoscopy number from 7176 in 1999 to 11,046 in 2009 was significant according to a log-linear regression test (p < 0.0001). The decrease in laparotomies from 3845 to 3567 was not significant (p = 0.190). Service volume shifts from local hospitals to regional hospitals were noted, with a concomitant decrease in the numbers of local hospitals. Laparoscopy was used more often than laparotomy among all three hospital accreditation levels. An increasing trend for choosing laparoscopy was observed for medical centers and local hospitals (p < 0.0001), but not regional hospitals (p = 0.0745). Laparoscopy was used more often in younger patients, by younger surgeons, and by male surgeons among hospitals at all three accreditation levels. Conclusion: Laparoscopy was preferentially used over laparotomy at all three hospital levels. An increasing trend for choosing laparoscopy was observed for medical centers and local hospitals, but not regional hospitals. Service volume shifts from local hospitals to regional hospitals were noted. Use of laparoscopy differed according to patient age, surgeon age, and surgeon gender among different hospital levels.http://www.sciencedirect.com/science/article/pii/S102845591300171Xbenign ovarian tumorlaparotomylaparoscopyNational Health Insurance Research Database (NHIRD)oophorectomy
spellingShingle Ming-Ping Wu
Chia-Jen Wu
Cheng-Yu Long
Chung-Han Ho
Kuan-Hui Huang
Chin-Chen Chu
Cheng-Yang Chou
Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan
Taiwanese Journal of Obstetrics & Gynecology
benign ovarian tumor
laparotomy
laparoscopy
National Health Insurance Research Database (NHIRD)
oophorectomy
title Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan
title_full Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan
title_fullStr Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan
title_full_unstemmed Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan
title_short Surgical trends for benign ovarian tumors among hospitals of different accreditation levels: An 11-year nationwide population-based descriptive study in Taiwan
title_sort surgical trends for benign ovarian tumors among hospitals of different accreditation levels an 11 year nationwide population based descriptive study in taiwan
topic benign ovarian tumor
laparotomy
laparoscopy
National Health Insurance Research Database (NHIRD)
oophorectomy
url http://www.sciencedirect.com/science/article/pii/S102845591300171X
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