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Treatment of perforated appendicitis in children: what is the cost?

Kate V Dennett1, Sarah Tracy, Sharon Fisher

  • 1Department of Surgery, Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.

Journal of Pediatric Surgery
|June 19, 2012
PubMed

Insights

Initial nonoperative management for perforated appendicitis in children resulted in higher hospital costs and longer stays, but similar indirect family costs compared to immediate appendectomy.

Area of Science:

  • Pediatric Surgery
  • Health Economics

Background:

  • Perforated appendicitis in children presents treatment challenges.
  • Comparing surgical and non-surgical management is crucial for cost-effectiveness.

Purpose of the Study:

  • To compare direct hospital costs and indirect family costs for immediate appendectomy versus initial nonoperative management in pediatric perforated appendicitis.

Main Methods:

  • Prospective study of 61 families using cost diaries for indirect costs.
  • Hospital financial databases used for direct cost assessment.
  • Mann-Whitney U and Fisher exact tests for statistical comparison.

Main Results:

  • Nonoperative management led to longer hospital stays (9 vs 7 days, P=.02).
  • Total hospital costs were significantly higher with nonoperative management ($31,349 vs $21,323, P=.01).
  • No significant differences in missed school or caregiver work days were observed.

Conclusions:

  • Initial nonoperative management for perforated appendicitis in children increases hospital length of stay and total costs.
  • Indirect costs to families (missed school/work days) were not significantly different between the two treatment strategies.
Abstract

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