Kokoska E R, Minkes R K, Silen M L, Langer J C, Tracy T F, Snyder C L, Dillon P A, Weber T R
Division of Pediatric Surgery, Department of Surgery, Cardinal Glennon Children's Hospital, 1465 South Grand Blvd, St Louis, MO 63104, USA.
Pediatrics. 2001 Jun;107(6):1298-301. doi: 10.1542/peds.107.6.1298.
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.
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 chi(2) analysis was performed on nominal data; data are depicted as mean +/- standard error of the mean.
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.
Younger children with appendicitis have reduced hospital days and charges when they are treated by PSs.
小儿急性阑尾炎的治疗由普通外科医生（GSs）和小儿外科医生（PSs）共同负责。我们的目的是研究由GSs或PSs提供的阑尾炎手术治疗的经济学情况。
将本州内接受阑尾炎手术治疗（1994年1月至1997年6月）的经委员会认证的GSs治疗的儿童结果与PSs的治疗结果进行比较。数据根据患者年龄进行分类，并根据《国际疾病分类》第九版进行诊断。对连续数据进行方差分析，对名义数据进行卡方分析；数据以平均值±平均标准误差表示。
与PSs（n = 1018；11.0±0.1岁对9.1±0.1岁）相比，GSs（n = 2178）治疗的儿童年龄更大，且治疗穿孔性阑尾炎的频率更低（18.8%对31.9%）。与接受GSs治疗的儿童相比，无论诊断为单纯性或穿孔性阑尾炎，接受PSs治疗的年幼儿童（0 - 4岁、5 - 8岁和9 - 12岁）住院时间明显更短和/或住院费用更低。然而，年龄较大的儿童（13 - 15岁）似乎有类似的结果。
患阑尾炎的年幼儿童由PSs治疗时，住院天数和费用会减少。
