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Related Experiment Videos

Appendicitis, 2002: relationship between payors and outcome.

Jeremy Schweitzer1, Nathan Fairman, Kristin Schreyer

  • 1Department of Surgical Education, Santa Barbara Cottage Hospital, Santa Barbara, California 93102, USA.

The American Surgeon
|October 23, 2003
PubMed
Summary

Health insurance status did not impact appendicitis diagnosis, treatment timeliness, or hospitalization costs in this study. Advanced appendicitis presentation was linked to pediatric and elderly patients, not insurance coverage.

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Area of Science:

  • Health Services Research
  • Surgical Outcomes
  • Health Economics

Background:

  • Health insurance status is a known determinant of healthcare access and quality.
  • Previous appendicitis studies suggest insurance impacts presentation stage and outcomes, but lacked detailed data.
  • Gaps exist in understanding how insurance affects appendicitis care specifics like timeliness and hospitalization costs.

Purpose of the Study:

  • To investigate if health insurance status influences the timeliness of diagnosis and treatment for acute appendicitis.
  • To determine if insurance status affects appendicitis presentation severity and hospitalization characteristics.
  • To examine the independent impact of age on appendicitis outcomes, irrespective of insurance status.

Main Methods:

  • Retrospective case-control study of 975 patients treated for acute appendicitis (1996-1999).

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  • Analysis of factors including time to operation, outpatient visits, diagnostic studies, presentation severity, and hospitalization details (length of stay, antibiotic duration, costs).
  • Statistical analysis using analysis of variance (ANOVA) techniques (P < 0.05 significant).

    • Main Results:

    • No significant correlation found between insurance status and the timeliness of appendicitis diagnosis or severity of presentation.
    • Hospitalization length of stay and costs did not differ significantly across insurance categories.
    • Pediatric (<12 years) and elderly (>65 years) patients independently presented with more advanced appendicitis.

    Conclusions:

    • In this community, health insurance coverage did not affect the treatment of acute appendicitis.
    • Age and timeliness of presentation emerged as the primary factors correlating with appendicitis outcomes.
    • Findings contrast with prior research, suggesting localized healthcare system factors may mitigate insurance-related disparities in appendicitis care.