Emergency Department, Unidade de Primeiro Atendimento, Hospital Israelita Albert Einstein, Avenida Albert Einstein, 627 - 1o Andar, 05651-901, São Paulo, Brazil.
BMC Emerg Med. 2013 Jul 26;13:15. doi: 10.1186/1471-227X-13-15.
Appendicitis is one of the most common surgical emergencies and is also a time-sensitive condition. Delays in treatment increase the risk of appendiceal perforation (AP), and thus AP rates have been used as a proxy to measure access to surgical care. It is very well known that in Brazil there are big differences between the public and private healthcare systems. Those differences can reflect in the treatment of what are considered simple cases, like appendicitis. As far as we know, it has no known links to behavioral or social risk factors, and has only one treatment option--appendectomy. The purpose of this study was to compare treatment received by Brazilian people, both by those who depend on the public and private healthcare system, and how it affects their outcome.
Data was collected from the records of all patients submitted to appendectomy, in a public and in a private Sao Paulo city's hospitals, during January to April of 2010.
Patients admitted by the public hospital present symptoms for a longer period of time than those treated by the private one. It took a significantly higher amount of time for the patients from the public hospital undergo surgery, and their length of stay is also significantly higher.
Appendicitis in a public scenario is associated with increased time from onset of symptoms to operative intervention and the main reason is the delayed presentation. Clinical polices for abdominal pain should be instituted by the public healthcare system, based on population education, healthcare professionals training and establishment of strategies that can speed the diagnosis process up.
阑尾炎是最常见的外科急症之一，也是一种需要及时治疗的疾病。治疗的延误会增加阑尾穿孔 (AP) 的风险，因此阑尾穿孔率被用作衡量获得外科治疗的指标。众所周知，巴西的公共和私人医疗保健系统之间存在很大差异。这些差异可能会反映在对阑尾炎等简单病例的治疗上。就我们所知，阑尾炎与行为或社会风险因素没有已知的联系，只有一种治疗选择——阑尾切除术。本研究的目的是比较巴西人在公共和私人医疗保健系统下接受的治疗方法，以及这对他们的结果有何影响。
从 2010 年 1 月至 4 月期间，在一家公立和一家私营圣保罗市医院接受阑尾切除术的所有患者的记录中收集数据。
在公立医院就诊的患者比在私立医院就诊的患者出现症状的时间更长。公立医院的患者接受手术的时间明显更长，住院时间也明显更长。
在公共医疗环境中，阑尾炎的发病到手术干预的时间延长，其主要原因是就诊时间延迟。公共医疗保健系统应根据人口教育、医疗保健专业人员培训以及制定可以加速诊断过程的策略，制定针对腹痛的临床政策。
