Journal of General Internal Medicine

, Volume 23, Issue 10, pp 1693–1697 | Cite as

Hospital Case Volume and Clinical Outcomes for Peptic Ulcer Treatment

  • Horng-Yuan Lou
  • Herng-Ching Lin
  • Kuan-Yang Chen
Original Article



No study has explored the volume–outcome relationship for peptic ulcer treatment.


To investigate the association between peptic ulcer case volume per hospital, on the one hand, and in-hospital mortality and 14-day readmission rates, on the other, using a nationwide population-based dataset.


A retrospective cross-sectional study, set in Taiwan.


There were 48,250 peptic ulcer patients included. Each patient was assigned to one of three hospital volume groups: low-volume (≤189 case), medium volume (190–410 cases), and high volume (≥411 cases).


Logistic regression analysis employing generalized estimating equations was used to examine the adjusted relationship of hospital volume with in-hospital mortality and 14-day readmission.

Main Results

After adjusting for other factors, results showed that the likelihood of in-hospital mortality for peptic ulcer patients treated by low-volume hospitals (mortality rate = 0.68%) was 1.6 times (p < 0.05) that of those treated in high-volume hospitals (mortality rate = 0.72%) and 1.4 times (p < 0.05) that of those treated in medium-volume hospitals (mortality rate = 0.73%). The adjusted odds ratio of 14-day readmission likewise declined with increasing hospital volume, with the odds of 14-day readmission for those patients treated by low-volume hospitals being 1.5 times (p < 0.001) greater than for high-volume hospitals and 1.3 times (p < 0.01) greater than for medium-volume hospitals.


We found that, after adjusting for other factors, peptic ulcer patients treated in the low-volume hospitals had inferior clinical outcomes compared to those treated in medium-volume or high-volume ones.


ulcer volume–outcome mortality 


Conflict of Interest

None disclosed.


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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Horng-Yuan Lou
    • 1
    • 2
  • Herng-Ching Lin
    • 3
  • Kuan-Yang Chen
    • 4
  1. 1.Department of Internal Medicine, Division of GastroenterologyTaipei Medical University HospitalTaipeiTaiwan
  2. 2.College of Medicine, Department of Internal MedicineTaipei Medical UniversityTaipeiTaiwan
  3. 3.School of Health Care AdministrationTaipei Medical UniversityTaipeiTaiwan
  4. 4.Ren-Ai Branch, Department of Internal Medicine, Division of GastroenterologyTaipei City HospitalTaipeiTaiwan

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