International Variation in Emergency Operation Rates for Acute Diverticulitis: Insights into Healthcare Value.

Area of Science:

• Surgical outcomes research
• Comparative healthcare analysis
• Gastrointestinal surgery

Background:

• Global focus on surgical quality, costs, and healthcare value.
• Acute diverticulitis is a common condition with potential for strategy optimization.
• Need for international comparison of emergency operative intervention rates for acute diverticulitis.

Purpose of the Study:

• To compare emergency operative intervention rates for acute diverticulitis.
• To analyze inpatient mortality and percutaneous drainage rates across countries.
• To investigate international variations in surgical management and outcomes.

Main Methods:

• Analysis of an international administrative dataset (2008-2014) for unplanned admissions.
• Inclusion of hospitals from the USA, England, and Australia.
• Multivariable analysis using a weighted comorbidity scoring system.

Main Results:

• Emergency operative intervention rates were 16% (USA), 13% (England), and 10% (Australia).
• USA had the highest percutaneous drainage rate (10%); England had the highest mortality rate (2.8%).
• Higher propensity for emergency surgery in USA and England; higher 7-day mortality risk in England.

Conclusions:

• Australia demonstrates a lower propensity for emergency operative intervention in acute diverticulitis.
• England shows a greater risk of mortality associated with acute diverticulitis management.
• International variations underscore the importance of healthcare value, resource utilization, and outcome differences.