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Management and Outcomes for Children with Acute Appendicitis Differ by Hospital Type: Areas for Improvement at Public Hospitals

Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York

Emily F. Stamell

Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York

Isaac Ezon, MD

Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York

Avi Schlager, MD

Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York

Howard B. Ginsburg, MD

Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York

Evan P. Nadler, MD

Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York, evan.nadler{at}med.nyu.edu

Background. Access to health care is a well-recognized issue in health policy, but use once patients have entered the health care system is uncommonly addressed. Methods. We performed a retrospective review of children between 2 and 17 years of age with pathologically confirmed appendicitis at our public city hospital and private university hospital and compared management and outcomes. Results. Among patients with acute appendicitis, the median length of stay was a day longer in the public hospital (2 days vs 1 day, P = <.001) despite a similar complication rate (12% vs 11%). More computed tomography (CT) scans were performed at the public hospital (36% vs 21%, P = .02) with a trend toward less use of ultrasound (US) (54% vs 65%, P = .13). Conclusions. Children at the public city hospital have a longer length of stay and undergo more expensive imaging. These findings may provide areas for improvement to optimize the care of children with appendicitis at government-funded institutions.

Key Words: appendicitis • outcomes • health care disparities • public hospitals

This version was published on June 1, 2009

Clinical Pediatrics, Vol. 48, No. 5, 499-504 (2009)
DOI: 10.1177/0009922809332586


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