Appendicitis Hospitalization Care Costs Among Patients With Delayed Diagnosis of Appendicitis

• DOI: 10.1001/jamanetworkopen.2024.6721
• Publication Date: 2024-04-15T15:32:02Z
• Authors: Dinushi A. Kulase...; Regina Royan; Ying Shan; Ana M. Reyes; Arielle C. Thomas; Alexander L. Lund...; Joe M. Feinglass; Anne M. Stey
• Keywords: Cohort Studies; Hospitalization; Inpatients; 03 medical and health sciences; Delayed Diagnosis; 0302 clinical medicine; Humans; Female; Appendicitis; Original Investigation

Importance Delayed appendicitis diagnosis is associated with worse outcomes. Appendicitis hospital care costs delayed are unknown. Objective To determine whether was increased costs. Design, Setting, and Participants This cohort study used data from patients receiving an appendectomy aged 18 to 64 years in 5 states (Florida, Maryland, Massachusetts, New York, Wisconsin) that were captured the Healthcare Cost Utilization Project State Inpatient Emergency Department databases for 2016 2017 no additional follow-up. Data analyzed January through April 2023. Exposures defined as a previous emergency department or inpatient encounter abdominal other than appendicitis, intervention 7 days prior encounter. Main Outcomes Measures The main outcome calculated aggregated charges of encounters appendectomy, encounter, 30 postoperatively. Cost-to-charge ratios applied obtain costs, which then adjusted wage index, inflation 2022 US dollar, extreme outliers winsorized. A multivariable Poisson regression estimated while controlling age, sex, race ethnicity, insurance status, discontinuity, income quartile, size, teaching medical school affiliation, percentage Black Hispanic patient discharges, core-based statistical area, state. Results There 76 183 (38 939 female [51.1%]; 2192 Asian Pacific Islander [2.9%], 14 132 [18.5%], 8195 non-Hispanic [10.8%], 46 949 White [61.6%]) underwent 2045 (2.7%) had diagnosis. median (IQR) unadjusted cost $11 099 ($6752-$17 740) compared $9177 ($5575-$14 481) nondelayed ( P < .001). Patients 1.23 times (95% CI, 1.16-1.28 times) mean marginal $2712 $2083-$3342). Even diagnosis, 1.22 1.17-1.28 patients. Conclusions Relevance In this study,