Association of Physician Certification Policy and Quality of Care: Evidence of percutaneous coronary intervention certification program in Taiwan

作者：Kao, Shu Hui; Lu, Dau Kuan; Lin, Yi Ling; Hsieh, Hui Min; Lin, Tsung Hsien; Chiu, Herng Chia^*

来源：Health Policy, 2015, 119(8): 1031-1038.

DOI：10.1016/j.healthpol.2015.03.006

• Certification program
• Percutaneous coronary intervention
• Certified interventional cardiologist
• Clinical outcome

Objectives: The aim of this study was to compare procedural, short-term and two-year outcomes of percutaneous coronary intervention (PCI) between board-certified and nonboard certified interventional cardiologists in Taiwan.
Background: Most studies of associations between quality and certification have analyzed populations in the Western developed countries.
Methods: This retrospective population-based study analyzed 2057 patients who had received PCI in 11 hospitals in 2007. The outcome measures were procedural, 30-day, and 2-year adverse events.
Results: Sixty certified physicians performed 1771 PCI procedures whereas 84 non-certified physicians performed 286 procedures. Patients treated by non-certified physicians had significantly higher rates of in-hospital mortality (6.99% vs. 2.82%, respectively; p <= 0.001) and same-stay CABG (1.40% vs. 0.06%, respectively; p <= 0.001). The results of multilevel logistic regression and Cox multivariate regression indicated that patients treated by non-certified physicians also had higher probabilities of in-hospital death (OR = 2.92, 95% CI: 1.20-7.08) and two-year death (hazard ratio, 1.63; 95% confidence interval, 1.18-2.24).
Conclusions: This is the first study in Asia in investigating the association between board certification policy and surgical outcomes, and the results confirmed that the board certification policy is also effective for Asian population. The policy implications of these findings are discussed.

• 出版日期2015-8
• 单位中山大学