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One-Year Healthcare Utilization and Costs After Emergency Department Encounters for Uncomplicated Appendicitis: A
Andrew C Meltzer1, Michael Makutonin2, Taylor Gorak3
1Department of Emergency Medicine The George Washington University School of Medicine and Health Sciences Washington, DC USA.
Annals of Gastroenterological Surgery
|July 24, 2026
Summary
Early appendectomy for uncomplicated appendicitis leads to lower one-year healthcare costs and reduced utilization compared to non-operative management. This suggests surgery may decrease long-term healthcare needs.
Area of Science:
- General Surgery
- Health Economics
- Health Services Research
Background:
- Non-operative management with antibiotics is an alternative to appendectomy for uncomplicated appendicitis.
- Comparative cost and utilization data are needed to inform clinical and policy decisions.
Purpose of the Study:
- To compare one-year healthcare costs and utilization outcomes between operative (appendectomy) and non-operative management of uncomplicated appendicitis.
Main Methods:
- Statewide observational study using linked Healthcare Cost and Utilization Project (HCUP) databases (2016-2021).
- Analysis of adult patients with uncomplicated appendicitis, excluding complicated cases.
- Inverse probability of treatment weighting and generalized linear models to adjust for covariates and estimate outcomes.
Main Results:
- Appendectomy (89.2%) was compared to non-operative management (10.8%) in 15,754 patients.
- Adjusted one-year costs were lower for appendectomy ($6241) vs. non-operative management ($8187).
- Appendectomy was associated with fewer ED revisits, readmissions, and shorter hospital stays (all p < 0.001).
Conclusions:
- Initial appendectomy for uncomplicated appendicitis is associated with lower one-year healthcare costs and reduced utilization.
- Early surgical intervention may decrease long-term healthcare utilization and associated costs.
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