Abstract
Background The lack of studies on the simultaneous contributions of hospital and physician to the length of stay (LOS) for acute myocardial infarction (AMI) has hampered the development of hospital- and physician-level strategies by clinicians and policymakers. This study used 3 years of population-based data to examine the relationships of physician and hospital characteristics with LOS for AMI patients in Taiwan. Methods and Results Multiple regression analysis was carried out to explore the relationships, using the 2001-2003 National Health Insurance Research Database of the National Health Research Institute, Taiwan. The study samples were identified by a principal diagnosis of AMI (ICD-9-CM code 410), with a total of 19,907 eligible admissions. The mean LOS was 9.1 days. The results revealed that compared with district hospitals, the LOS was significantly longer in both medical centers and regional hospitals (both p<0.001). The LOS among patients attended by cardiologists was 28.0% shorter than those attended by physicians specializing in surgery, family medicine, or emergency medicine. Conclusions The results of this study demonstrate that there are wide variations among the different types of physician and levels of hospital in the LOS for AMI patients, which highlights the importance of developing national treatment protocols for AMI in order to reduce variations in hospital and physician behaviors. (Circ J 2006; 70: 679 - 685)
