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Published on: February 28, 2025
Study of social disparities in pediatric laparoscopic appendectomy outcomes and cost
1Winthrop University Hospitals, Mineola, NY, USA.
Insights
This study found no significant differences in surgical outcomes or costs for pediatric laparoscopic appendectomies between racial groups. Standardized care protocols appear to minimize racial disparities in this common emergency procedure.
Area of Science:
- Pediatric Surgery
- Health Disparities Research
- Surgical Outcomes Analysis
Background:
- Growing attention to racial and social disparities in healthcare.
- Existing research highlights outcome disparities in adult surgery, but less is known about pediatric surgical outcomes.
- Investigating racial disparities in pediatric surgical care is crucial for equitable healthcare.
Purpose of the Study:
- To examine the impact of race on complications and costs following laparoscopic appendectomy in children.
- To determine if racial or ethnic background influences surgical outcomes in pediatric appendicitis.
- To assess cost-effectiveness across different racial groups for a common pediatric surgical procedure.
Main Methods:
- Retrospective chart review of 248 pediatric patients undergoing appendectomy for acute appendicitis (2015-2017).
- Patients categorized into minority (African American/Hispanic) and non-minority (Caucasian) groups.
- Comparison of length of stay, pre/postoperative factors, and total costs between groups.
Main Results:
- Analysis included 185 eligible patients: 45.9% minority, 54.1% Caucasian.
- Comorbidity rates were similar: 11.8% in minority vs. 12% in majority patients (p=1).
- Readmission rates (3.5% vs. 2%) and average costs ($30,900 vs. $31,111) showed no significant differences between groups (p=0.7 and p=0.59, respectively).
Conclusions:
- Standardized care protocols have been effective in mitigating social and racial disparities in surgical outcomes.
- Laparoscopic appendectomy, a frequent pediatric emergency surgery, demonstrated no disparities in outcomes or costs between minority and Caucasian children.
- This suggests that established protocols ensure equitable care for this procedure regardless of race.
Purpose:
There is an increasing focus on racial and social disparities in health care. There have been several studies that have documented disparities in outcome between racial groups in the adult literature. Not much is known about disparities in outcomes after surgical procedures in children. The purpose of this study was to investigate the effect of race on complications (outcomes) and costs after laparoscopic appendectomy.
Methods:
This study is a single-center retrospective chart review of 248 pediatric patients who underwent appendectomies for uncomplicated acute appendicitis from 2015 to 2017. Patients were divided into minority (Africa American or Hispanic) and non-minority groups, and length of stay, preoperative and postoperative factors, and total costs were compared.
Results:
Of 185 eligible patients, 45.9% (n = 85) were of Hispanic or African American ethnicity and 54.1% (n = 100) were Caucasian. About 11.8% of minority patients had comorbidities and 12% of majority patients had comorbidities (p = 1). Readmission rate for minority group patients was 3.5% (n = 3) and 2% (n = 2) for majority patients (p = 0.7). The average cost of hospital stay for minority patients was $30,900 and for majority patients was $31,111 (p = 0.59).
Conclusions:
Standardization of care protocols has reduced social/racial disparities in surgical outcomes. In the most common pediatric surgery emergency procedure, laparoscopic appendectomy, there were no differences in outcomes or costs between minority (Hispanic/Africa American) and Caucasian ethnic groups.
Level Of Evidence:
Level III.
Type Of Study:
Clinical Study.
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