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Pediatric appendicitis rupture rate: disparities despite universal health care

Ioana Bratu1, Patricia J Martens, William D Leslie

  • 1Department of Pediatric General Surgery, Faculty of Medicine, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada. bratu@ualberta.ca

Journal of Pediatric Surgery
|October 31, 2008
PubMed

Insights

Children from lower socioeconomic status (SES) areas experience higher rates of appendiceal rupture, even with universal healthcare. This suggests socioeconomic factors impact timely medical access and appendicitis outcomes.

Area of Science:

  • Pediatric Surgery
  • Public Health
  • Health Services Research

Background:

  • Socioeconomic disparities in perforated appendicitis are documented in private healthcare systems.
  • The Canadian universal healthcare system aims to mitigate such disparities.

Purpose of the Study:

  • To investigate if pediatric appendicitis rupture rates in Canada indicate underlying health disparities.
  • To assess the association between socioeconomic status and appendiceal rupture in children.

Main Methods:

  • Retrospective analysis of 7475 pediatric appendicitis cases (1983-2003).
  • Utilized the Population Health Research Data Repository.
  • Multivariate logistic regression analyzed socioeconomic status (SES) and rupture rates, adjusting for demographic and geographic factors.

Main Results:

  • Overall appendiceal rupture rate was 28.8%.
  • Lower rural and urban SES were significant predictors of appendiceal rupture.
  • Younger age, northern residence, and treatment at a tertiary care hospital also increased rupture risk.

Conclusions:

  • Children from lower SES areas have higher appendiceal rupture rates, despite universal healthcare.
  • Social, behavioral, and geographical factors may impede access to timely medical care.
  • Appendiceal rupture rates can serve as an indicator of health disparities in universal healthcare systems.
Abstract

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