Evaluation of race and insurance status as predictors of undergoing laparoscopic appendectomy in children

Benjamin A. Hagendorf, Jiangang (Jason) Liao, Mitchell R. Price, Randall S. Burd

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: The objective of this study was to determine the relationship of race and socioeconomic factors and the method used for appendectomies in children (open vs. laparoscopic). SUMMARY BACKGROUND DATA: Previous studies have shown racial and insurance-related differences associated with the management of appendicitis in adults. It is not known whether these differences are observed in children. METHODS: Children (<15 years) undergoing appendectomy from 1996 to 2002 were identified in the Nationwide Inpatient Sample. Severity of appendicitis and underlying chronic illnesses were determined by ICD-9 codes. Hospital characteristics evaluated included teaching status and location, children's hospital status, and volume of appendectomies. Hierarchical unadjusted and risk-adjusted logistic regression analyses were performed. RESULTS: Among 72,189 children undergoing an appendectomy for appendicitis, 11,714 (16%) underwent a laparoscopic appendectomy. Multivariate analysis showed that whites were more likely to undergo a laparoscopic appendectomy than blacks (odds ratio, 1.14; 95% CI, 1.03-1.25, P = 0.01) but not other races. A significant interaction between payer source and children's hospital designation was observed, with the odds of children with private insurance undergoing laparoscopic appendectomy being significantly higher than those without private insurance at nonchildren's hospitals but not at children's hospitals. CONCLUSIONS: There are significant racial and insurance-related differences in use of laparoscopic appendectomy in children that are most evident at nonchildren's hospitals. These findings provide evidence that factors at hospitals dedicated to children may lead to better access to new technologies.

Original languageEnglish (US)
Pages (from-to)118-125
Number of pages8
JournalAnnals of surgery
Volume245
Issue number1
DOIs
StatePublished - Jan 1 2007

Fingerprint

Appendectomy
Insurance Coverage
Insurance
Appendicitis
International Classification of Diseases
Inpatients
Teaching
Chronic Disease
Multivariate Analysis
Logistic Models
Odds Ratio
Regression Analysis
Technology

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Hagendorf, Benjamin A. ; Liao, Jiangang (Jason) ; Price, Mitchell R. ; Burd, Randall S. / Evaluation of race and insurance status as predictors of undergoing laparoscopic appendectomy in children. In: Annals of surgery. 2007 ; Vol. 245, No. 1. pp. 118-125.
@article{388608ff8a294737879d55b1cdd657e9,
title = "Evaluation of race and insurance status as predictors of undergoing laparoscopic appendectomy in children",
abstract = "OBJECTIVE: The objective of this study was to determine the relationship of race and socioeconomic factors and the method used for appendectomies in children (open vs. laparoscopic). SUMMARY BACKGROUND DATA: Previous studies have shown racial and insurance-related differences associated with the management of appendicitis in adults. It is not known whether these differences are observed in children. METHODS: Children (<15 years) undergoing appendectomy from 1996 to 2002 were identified in the Nationwide Inpatient Sample. Severity of appendicitis and underlying chronic illnesses were determined by ICD-9 codes. Hospital characteristics evaluated included teaching status and location, children's hospital status, and volume of appendectomies. Hierarchical unadjusted and risk-adjusted logistic regression analyses were performed. RESULTS: Among 72,189 children undergoing an appendectomy for appendicitis, 11,714 (16{\%}) underwent a laparoscopic appendectomy. Multivariate analysis showed that whites were more likely to undergo a laparoscopic appendectomy than blacks (odds ratio, 1.14; 95{\%} CI, 1.03-1.25, P = 0.01) but not other races. A significant interaction between payer source and children's hospital designation was observed, with the odds of children with private insurance undergoing laparoscopic appendectomy being significantly higher than those without private insurance at nonchildren's hospitals but not at children's hospitals. CONCLUSIONS: There are significant racial and insurance-related differences in use of laparoscopic appendectomy in children that are most evident at nonchildren's hospitals. These findings provide evidence that factors at hospitals dedicated to children may lead to better access to new technologies.",
author = "Hagendorf, {Benjamin A.} and Liao, {Jiangang (Jason)} and Price, {Mitchell R.} and Burd, {Randall S.}",
year = "2007",
month = "1",
day = "1",
doi = "10.1097/01.sla.0000242715.66878.f8",
language = "English (US)",
volume = "245",
pages = "118--125",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Evaluation of race and insurance status as predictors of undergoing laparoscopic appendectomy in children. / Hagendorf, Benjamin A.; Liao, Jiangang (Jason); Price, Mitchell R.; Burd, Randall S.

In: Annals of surgery, Vol. 245, No. 1, 01.01.2007, p. 118-125.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of race and insurance status as predictors of undergoing laparoscopic appendectomy in children

AU - Hagendorf, Benjamin A.

AU - Liao, Jiangang (Jason)

AU - Price, Mitchell R.

AU - Burd, Randall S.

PY - 2007/1/1

Y1 - 2007/1/1

N2 - OBJECTIVE: The objective of this study was to determine the relationship of race and socioeconomic factors and the method used for appendectomies in children (open vs. laparoscopic). SUMMARY BACKGROUND DATA: Previous studies have shown racial and insurance-related differences associated with the management of appendicitis in adults. It is not known whether these differences are observed in children. METHODS: Children (<15 years) undergoing appendectomy from 1996 to 2002 were identified in the Nationwide Inpatient Sample. Severity of appendicitis and underlying chronic illnesses were determined by ICD-9 codes. Hospital characteristics evaluated included teaching status and location, children's hospital status, and volume of appendectomies. Hierarchical unadjusted and risk-adjusted logistic regression analyses were performed. RESULTS: Among 72,189 children undergoing an appendectomy for appendicitis, 11,714 (16%) underwent a laparoscopic appendectomy. Multivariate analysis showed that whites were more likely to undergo a laparoscopic appendectomy than blacks (odds ratio, 1.14; 95% CI, 1.03-1.25, P = 0.01) but not other races. A significant interaction between payer source and children's hospital designation was observed, with the odds of children with private insurance undergoing laparoscopic appendectomy being significantly higher than those without private insurance at nonchildren's hospitals but not at children's hospitals. CONCLUSIONS: There are significant racial and insurance-related differences in use of laparoscopic appendectomy in children that are most evident at nonchildren's hospitals. These findings provide evidence that factors at hospitals dedicated to children may lead to better access to new technologies.

AB - OBJECTIVE: The objective of this study was to determine the relationship of race and socioeconomic factors and the method used for appendectomies in children (open vs. laparoscopic). SUMMARY BACKGROUND DATA: Previous studies have shown racial and insurance-related differences associated with the management of appendicitis in adults. It is not known whether these differences are observed in children. METHODS: Children (<15 years) undergoing appendectomy from 1996 to 2002 were identified in the Nationwide Inpatient Sample. Severity of appendicitis and underlying chronic illnesses were determined by ICD-9 codes. Hospital characteristics evaluated included teaching status and location, children's hospital status, and volume of appendectomies. Hierarchical unadjusted and risk-adjusted logistic regression analyses were performed. RESULTS: Among 72,189 children undergoing an appendectomy for appendicitis, 11,714 (16%) underwent a laparoscopic appendectomy. Multivariate analysis showed that whites were more likely to undergo a laparoscopic appendectomy than blacks (odds ratio, 1.14; 95% CI, 1.03-1.25, P = 0.01) but not other races. A significant interaction between payer source and children's hospital designation was observed, with the odds of children with private insurance undergoing laparoscopic appendectomy being significantly higher than those without private insurance at nonchildren's hospitals but not at children's hospitals. CONCLUSIONS: There are significant racial and insurance-related differences in use of laparoscopic appendectomy in children that are most evident at nonchildren's hospitals. These findings provide evidence that factors at hospitals dedicated to children may lead to better access to new technologies.

UR - http://www.scopus.com/inward/record.url?scp=33845986750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845986750&partnerID=8YFLogxK

U2 - 10.1097/01.sla.0000242715.66878.f8

DO - 10.1097/01.sla.0000242715.66878.f8

M3 - Article

VL - 245

SP - 118

EP - 125

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 1

ER -