Cost and Late Hospital Care of Publicly Insured Children After Appendectomy

Area of Science:

• Pediatric Surgery
• Healthcare Management
• Public Health

Background:

• Appendicitis is a common pediatric condition.
• While immediate complications are frequent, long-term sequelae remain understudied.
• Understanding long-term care needs is crucial for comprehensive appendicitis management.

Purpose of the Study:

• To determine the prevalence and cost of late hospital care following pediatric appendicitis.
• To identify risk factors associated with late hospital care in children.
• To inform targeted prevention strategies for appendicitis complications.

Main Methods:

• Analysis of administrative claims data for publicly insured US children diagnosed with appendicitis (2018-2019).
• Defined late hospital care as hospitalization or abdominal procedure within 180 days of discharge, excluding interval appendectomies.
• Utilized Cox regression to assess time to late hospital care and evaluated associated healthcare expenditures.

Main Results:

• 6.0% of 95,942 children experienced late hospital care, with 2.1% requiring surgery.
• Younger children (under 5), those with complex chronic conditions, and complicated appendicitis cases had significantly higher risks.
• Median healthcare expenditures were substantially higher for children requiring late hospital care ($19,589 vs. $6,553).

Conclusions:

• Late hospital care following pediatric appendicitis is infrequent but associated with significant healthcare costs.
• Prevention strategies should prioritize high-risk groups: very young children, those with complex comorbidities, and cases of complicated appendicitis.
• Further research into long-term outcomes and cost-effectiveness of interventions is warranted.