Effect of pediatric surgical practice on the treatment of children with appendicitis

Objective. Acute appendicitis in children is managed by both general surgeons (GSs) and pediatric surgeons (PSs). Our objective was to investigate the economics of surgical care provided by either GSs or PSs for appendicitis. Methods. The outcome of children within our state who underwent operative treatment for appendicitis (January 1994 to June 1997) by board-certified GSs were compared with the results of PSs. Data were sorted according to patient age and diagnosis according to the International Classification of Diseases, Ninth Revision. Analysis of variance was performed on continuous data, and χ² analysis was performed on nominal data; data are depicted as mean ± standard error of the mean. Results. GSs (n = 2178) managed older children when compared with PSs (n = 1018; 11.0 ± 0.1 vs 9.1 ± 0.1 years) and less frequently treated perforated appendicitis (18.8% vs 31.9%). Independent of diagnosis (simple or perforated appendicitis), younger children (0-4 years, 5-8 years, and 9-12 years) who were treated by PSs had a significantly shorter hospital stay and/or decreased hospital charge when compared with those who were treated by GSs. However, older children (13-15 years) seemed to have comparable outcomes. Conclusions. Younger children with appendicitis have reduced hospital days and charges when they are treated by PSs.