Management and outcomes for children with acute appendicitis differ by hospital type: areas for improvement at public hospitals.

BACKGROUND: Access to health care is a well-recognized issue in health policy, but use once patients have entered the health care system is uncommonly addressed.

METHODS: We performed a retrospective review of children between 2 and 17 years of age with pathologically confirmed appendicitis at our public city hospital and private university hospital and compared management and outcomes.

RESULTS: Among patients with acute appendicitis, the median length of stay was a day longer in the public hospital (2 days vs 1 day, P = <.001) despite a similar complication rate (12% vs 11%). More computed tomography (CT) scans were performed at the public hospital (36% vs 21%, P = .02) with a trend toward less use of ultrasound (US) (54% vs 65%, P = .13).

CONCLUSIONS: Children at the public city hospital have a longer length of stay and undergo more expensive imaging. These findings may provide areas for improvement to optimize the care of children with appendicitis at government-funded institutions.