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

Objective. Acute appendicitis in children is managed by both general surgeo ns (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 t reatment for appendicitis (January 1994 to June 1997) by board-certified GS s were compared with the results of PSs. Data were sorted according to pati ent age and diagnosis according to the International Classification of Dise ases, Ninth Revision. Analysis of variance was performed on continuous data , and chi (2) 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 perfor ated appendicitis (18.8% vs 31.9%). Independent of diagnosis (simple or per forated appendicitis), younger children (0-4 years, 5-8 years, and 9-12 yea rs) who were treated by PSs had a significantly shorter hospital stay and/o r decreased hospital charge when compared with those who were treated by GS s. 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.