There are significant socioeconomic disparities in the rates of perforated appendicitis among children in private health care.
Dr Ioana Bratua and colleagues from Canada explored whether pediatric appendicitis rupture rates are an indicator of health disparities in the Canadian system of public, universal health care access.
The team used the Population Health Research Data Repository housed at Manitoba Centre for Health Policy.
The research team conducted a retrospective analysis over a 20-year period from 1983 to 2003.
|The overall appendiceal rupture rate was 29%|
|Journal of Pediatric Surgery |
The team examined 7475 patients aged less than 18 years with International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic and procedural codes for appendicitis.
The team used multivariate logistic regression analysis to calculate odds ratios in the association between appendiceal rupture rates and the patient's socioeconomic status.
The researchers based the patient’s socioeconomic status on average household income of the census area adjusted for age, sex, area of residence, and treating hospital.
The researchers found that the overall appendiceal rupture rate was 29%.
Significant positive predictors of appendiceal rupture were lower rural socioeconomic status, lower urban socioeconomic status, younger age, and northern area of residence.
In addition, the team noted that receiving treatment at the province's only pediatric tertiary care hospital was also a positive predictor of appendicle rupture.
Dr Bratua’s team concluded, “Despite free, universal access health care, children from lower socioeconomic status areas have increased appendiceal rupture rates.”
“Seeking and accessing medical attention can be complicated by social, behavioral, and geographical problems.”