Abstract
Background/Purpose
We compared direct hospital costs and indirect costs to the family associated with
immediate appendectomy or initial nonoperative management for perforated appendicitis
in children.
Methods
From June 2009 through May 2010, 61 prospectively identified families completed a
cost diary, documenting the numbers of missed school days for the child and missed
employment days for the adult caregiver(s) over the treatment course. Hospital costs
were obtained from hospital financial databases. Mann-Whitney U tests and Fisher exact tests were used to compare outcome measures for each treatment
strategy.
Results
Patients treated by initial nonoperative management had a significantly longer median
length of stay (9 days vs 7 days, P = .02) and a significantly greater median total hospital cost per patient ($31,349
vs $21,323, P = .01) when compared with those treated by immediate appendectomy. There was no significant
difference in median number of missed school days (9 days vs 10 days, P = .23) or missed employment days for adult caregiver(s) (5 days vs 7 days, P = .18) between treatment strategies.
Conclusions
Patients with perforated appendicitis treated by initial nonoperative management had
a greater length of stay and a significantly greater total hospital cost but were
not burdened by significantly greater indirect costs compared with those treated by
immediate appendectomy.
Abbreviations:
BMI (body mass index), CHB (Children's Hospital Boston), CHRIs PR–Demographics (Child Health Ratings Inventory Parent Report–Demographics), IQR (interquartile range), IR (interventional radiology), IRB (institutional review board), IV (intravenous), LOS (length of stay), PICC (percutaneously inserted central catheter), RLQ (right lower quadrant), SD (standard deviation), SSI (surgical site infection), TPN (total parenteral nutrition), UTI (urinary tract infection), WBC (white blood cell.)Key words
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Article info
Publication history
Accepted:
March 6,
2012
Received:
February 25,
2012
Footnotes
☆Presented at the American Academy of Pediatrics 2011 National Conference and Exhibition, Boston, MA; October 15-18, 2011.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
