Related Experiment Video
Updated: Feb 8, 2026
Detection of Polyfunctional T Cells in Children Vaccinated with Japanese Encephalitis Vaccine via the Flow Cytometry Technique
Published on: September 23, 2022
Perforated appendicitis in children: equal access to care eliminates racial and socioeconomic disparities
Steven L Lee1, Shant Shekherdimian, Vicki Y Chiu
1Division of Pediatric Surgery, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA 90027, USA. slleemd@yahoo.com
Insights
Equal access to healthcare eliminates racial and socioeconomic disparities in pediatric appendicitis outcomes. This study found no increased risk of appendiceal perforation (AP) or prolonged hospitalization (LOH) for minority or low-income children when care is equitable.
Area of Science:
- Pediatric Surgery
- Health Services Research
- Health Equity
Background:
- Racial and socioeconomic disparities in appendicitis outcomes are well-documented in pediatric populations.
- Existing literature suggests unequal access to care contributes to these disparities.
Purpose of the Study:
- To investigate if equitable access to healthcare mitigates racial and socioeconomic disparities in pediatric appendicitis outcomes.
- To analyze the impact of equal healthcare access on appendiceal perforation (AP) rates and length of hospitalization (LOH).
Main Methods:
- Retrospective review of 7,247 patients under 18 years old treated for appendicitis over a decade.
- Analysis of appendiceal perforation (AP) rates and length of hospitalization (LOH) as primary outcomes.
- Independent variables included race, annual median per capita income, and parental education level.
Main Results:
- No significant differences in AP rates were observed across racial groups or socioeconomic statuses (income, education).
- Adjusted length of hospitalization (LOH) was longer for Black children compared to White children.
- Shorter LOH was noted in high-income families compared to low-income families, with no difference for medium-income families.
Conclusions:
- Equal access to healthcare appears to eliminate disparities in appendiceal perforation (AP) rates among children.
- While some length of hospitalization (LOH) differences persist, the primary disparities in AP are preventable with equitable care.
- These findings underscore the critical role of healthcare access in achieving equitable pediatric appendicitis outcomes.
Purpose:
The aim of the study was to determine whether equal access to health care eliminates racial and socioeconomic disparities in appendicitis outcomes.
Methods:
A review of patients younger than 18 years treated for appendicitis for a decade was performed. Outcomes were appendiceal perforation (AP) rate and length of hospitalization (LOH). Independent variables included racial status, annual median per capita income, and parental education level.
Results:
Seven thousand two hundred forty-seven patients were identified (mean age, 11.6 years; 62% male). The adjusted odds ratio (OR) for AP was similar in blacks, Hispanics, and Asians compared to whites. The OR for AP was similar in high- and medium-income families compared to low-income families. The OR for AP was similar in high and medium parental education levels compared to low parental education levels. The adjusted LOH was longer in blacks and similar in Hispanics and Asians compared to whites. The LOH was shorter in high- and similar in medium-income families compared to low-income families. The LOH was similar in all parental education levels.
Conclusion:
Lower socioeconomic background and minority status did not correlate with higher appendiceal perforation rates or a clinically longer LOH in children with equal access to care. The previously reported disparities in pediatric appendicitis outcome are preventable with equal access to care.
