Relationship Between Caseload Volume and Outcome for Systemic Lupus Erythematosus Treatment: The Experience of Taiwan

Objective To determine if a physician’s experience or hospital caseload volume is associated with in-hospital mortality of patients with systemic lupus erythematosus (SLE). Methods We used data from Taiwan’s National Health Insurance Research Database covering 2002 to 2004. A total of 8536 hospital admissions citing a principal diagnosis of SLE were selected. Hospitals with an average of > 50, 26–50, and 3 cases per year). Multivariate logistic regression analyses employing generalized estimated equations were performed to assess the independent association between physician or hospital SLE caseload volume and inhospital mortality, after adjusting for other factors. Results We found that in-hospital mortality declined with increasing physician caseload volume (3.0%, 1.0%, and 0.8% for low, medium, and high-volume physicians, respectively), with the adjusted odds of in-hospital mortality for patients treated by low-volume physicians being 2.681 (p Conclusion We concluded that the factor of physicians’ experience treating SLE is more crucial in determining in-hospital mortality than a hospital’s annual SLE caseload.