Zilbert Nathan R, Stamell Emily F, Ezon Isaac, Schlager Avi, Ginsburg Howard B, Nadler Evan P
Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York, USA.
Clin Pediatr (Phila). 2009 Jun;48(5):499-504. doi: 10.1177/0009922809332586. Epub 2009 Feb 27.
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.
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.
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).
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.
获得医疗保健是卫生政策中一个广为人知的问题，但患者进入医疗保健系统后的使用情况却很少得到关注。
我们对在我市公立医院和私立大学医院经病理确诊为阑尾炎的2至17岁儿童进行了回顾性研究，并比较了治疗方法和结果。
在急性阑尾炎患者中，尽管并发症发生率相似（分别为12%和11%），但公立医院的中位住院时间长一天（2天对1天，P =<.001）。公立医院进行的计算机断层扫描（CT）更多（36%对21%，P =.02），而超声（US）的使用有减少趋势（54%对65%，P =.13）。
市公立医院的儿童住院时间更长，接受的影像学检查费用更高。这些发现可能为优化政府资助机构中阑尾炎儿童的护理提供改进方向。
