Hospital type plays a role in racial disparities and appendicitis outcomes in children

Published on December 29, 2012 at 6:30 AM · No Comments

Study authors explain that findings published in Journal of American College of Surgeons point to the need for further research on why these racial disparities exist and what preventive interventions can be developed

When researchers from UCLA Medical Center investigated the link between racial disparities and appendicitis outcomes in children, they found that the type of hospital in which black, Hispanic and other minority patients receive care-community, children's or county-affects their odds of developing a perforated appendix. The study published in the January issue of the Journal of the American College of Surgeons is a first-of-its-kind look at the role hospital type plays in race-based treatment variances among this patient subset.

Appendicitis-a painful, inflamed appendix-is the most common reason for emergency abdominal surgery in children. Approximately 80,000 pediatric cases are diagnosed in the U.S. annually.* Since the inflamed appendix can sometimes become perforated if the condition is not treated in a timely fashion (usually one to two days from the time symptoms first appear), researchers have used appendix perforation as a marker for inadequate access to health care. While existing research shows that a number of factors (such as age, socioeconomic status, the distance a family lives from a hospital) increase the risk for developing a perforated appendix in minorities, these factors don't tell the whole story.

"Appendicitis is a time-dependent disease process that leads to more a complicated medical outcome, and that outcome, perforated appendicitis, has increased hospital costs and increased burden to both the patient and society," according to study author Stephen Shew, MD, FACS, associate professor of surgery, UCLA Medical Center, and a pediatric surgeon at Mattel Children's hospital, both in Los Angeles.

To determine whether there is a link between hospital type and racial disparities, as measured by appendiceal perforation (AP), Dr. Shew and colleagues looked at data from the California Patient Discharge Dataset. Their analysis involved 107,727 children between the ages of two and 18 years old who were treated for appendicitis at 386 California hospitals between 1999 and 2007. Of these children, 53 percent were Hispanic, 36 percent were white, 3 percent were black, 5 percent were Asian, and 8 percent were of an unknown race. The children were sorted by hospital type, which included community, children's and county hospitals.

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