Perforated appendicitis in children: equal access to care eliminates racial and socioeconomic disparities

Lee, Steven L.; Shekherdimian, Shant; Chiu, Vicki; Sydorak, Roman M.

doi:10.1016/j.jpedsurg.2010.02.089

Cited by 53 publications

(30 citation statements)

References 12 publications

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“…Studies have assessed what factors account for differences in LOS after appendectomy across ethnicity in both adult [25] and pediatric [26] patients, but the relationship between ethnicity and LOS remains unclear in the literature. Differences may be attributed to culture differences, home dynamics, and socioeconomic factors, but future work is necessary to clarify exactly what factors influence LOS across ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

Variability in same-day discharge for pediatric appendicitis

Oyetunji

Gonzalez

Aguayo

et al. 2015

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Variability in same-day discharge for pediatric appendicitis

Oyetunji

Gonzalez

Aguayo

et al. 2015

Journal of Surgical Research

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“…All members have equal access to any of the Kaiser Permanente clinics, emergency rooms, or medical centers, thus gaving us the unique opportunity for controlling for healthcare access. Our initial studies demonstrated that racial and socioeconomic disparities with respect to appendiceal perforation rate and length of hospitalization were eliminated in both children and adults in the setting of equal health care access [8,9]. Having shown that access to surgical care was equal among all race/ethnic groups and all socioeconomic levels, the purpose of this study was to determine whether disparities exist with respect to the management of appendicitis in a similar setting.…”

Section: Discussionmentioning

confidence: 99%

“…Differences in race and socioeconomic status have led to marked differences in appendiceal perforation rates [1][2][3][4][5][6][7]. However, when patients had equal access to care, these differences were eliminated [8,9].…”

Section: Introductionmentioning

confidence: 99%

Equal Access to Healthcare Does Not Eliminate Disparities in the Management of Adults with Appendicitis

Lee

Yaghoubian

Stark

et al. 2011

Journal of Surgical Research

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“…11 However, others have shown that racial differences in ruptured appendicitis disappeared after adjusting for access to care. 12 Still others have reported no racial disparities in the rate of rupture. 13,14 We did not look specifically for rates of rupture in our study, and the data overall are mixed.…”

Section: Racial Differencesmentioning

confidence: 97%

Race and Acute Abdominal Pain in a Pediatric Emergency Department

2013

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WHAT'S KNOWN ON THIS SUBJECT: Abdominal pain is a frequent complaint in pediatric emergency departments, with a broad differential diagnosis. The impact of demographic and clinical characteristics of patients on the evaluation and management of these children is not well known. WHAT THIS STUDY ADDS:The most common cause of abdominal pain is constipation, which rarely requires hospital admission. Demographic factors, in particular race, do not seem to affect evaluation and management. abstract OBJECTIVE: To investigate the demographic and clinical factors of children who present to the pediatric emergency department (ED) with abdominal pain and their outcomes. METHODS:A review of the electronic medical record of patients 1 to 18 years old, who presented to the Children' s Hospital of Pittsburgh ED with a complaint of abdominal pain over the course of 2 years, was conducted. Demographic and clinical characteristics, as well as visit outcomes, were reviewed. Subjects were grouped by age, race, and gender. Results of evaluation, treatment, and clinical outcomes were compared between groups by using multivariate analysis and recursive partitioning.RESULTS: There were 9424 patient visits during the study period that met inclusion and exclusion criteria. Female gender comprised 61% of African American children compared with 52% of white children. Insurance was characterized as private for 75% of white and 37% of African American children. A diagnosis of appendicitis was present in 1.9% of African American children and 5.1% of white children. Older children were more likely to be admitted and have an operation associated with their ED visit. Appendicitis was uncommon in younger children. Constipation was commonly diagnosed. Multivariate analysis by diagnosis as well as recursive partitioning analysis did not reflect any racial differences in evaluation, treatment, or outcome.CONCLUSIONS: Constipation is the most common diagnosis in children presenting with abdominal pain. Our data demonstrate that no racial differences exist in the evaluation, treatment, and disposition of children with abdominal pain. Dr Caperell conceptualized and designed the study, carried out the analyses, drafted the initial manuscript, and revised the manuscript; Dr Pitetti guided the study design and the initial analyses, and reviewed and revised the manuscript; Dr Cross performed the recursive partitioning portion of the analysis, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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Perforated appendicitis in children: equal access to care eliminates racial and socioeconomic disparities

Cited by 53 publications

References 12 publications

Variability in same-day discharge for pediatric appendicitis

Variability in same-day discharge for pediatric appendicitis

Equal Access to Healthcare Does Not Eliminate Disparities in the Management of Adults with Appendicitis

Race and Acute Abdominal Pain in a Pediatric Emergency Department

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