Detmer D E, Frisch C
Med Decis Making. 1984;4(2):217-27. doi: 10.1177/0272989X8400400209.
The Wisconsin Professional Review Organization compared acute appendectomies being performed in 1981 to those done in 1978 in 32 Wisconsin hospitals. In both years approximately 75 percent of primary appendectomies were in patients 5 to 30 years of age, one-fourth were in patients 15 to 19 years of age, and the majority were in males. Incidence of normal appendices dropped from 16.1 percent in 1978 to 11.4 percent in 1981 (p less than 0.005). The number of patients with normal appendices who did not meet symptom criteria dropped from 37.3 percent to 9.5 percent (p less than 0.05). Incidence of normal appendices was highest in small hospitals. Severity and ruptures or perforations increased, but not significantly. Postoperative complications and mortality decreased. Average length of stay decreased overall, but increased for patients with complications and ruptures or perforations. These data suggest that areawide reviews assure quality and help contain costs. Physician self-regulation using areawide studies may produce desirable change.
威斯康星州专业评审机构将1981年在威斯康星州32家医院进行的急性阑尾切除术与1978年的进行了比较。在这两年中，约75%的初次阑尾切除术患者年龄在5至30岁之间，四分之一在15至19岁之间，且大多数为男性。正常阑尾的发生率从1978年的16.1%降至1981年的11.4%（p<0.005）。不符合症状标准的正常阑尾患者数量从37.3%降至9.5%（p<0.05）。正常阑尾的发生率在小医院最高。严重程度以及破裂或穿孔有所增加，但不显著。术后并发症和死亡率下降。总体住院时间缩短，但有并发症以及破裂或穿孔的患者住院时间增加。这些数据表明，区域范围内的评审可确保质量并有助于控制成本。利用区域范围内的研究进行医生自我监管可能会产生理想的变化。
