title: Hospital characteristics affect outcomes for common pediatric surgical conditions.
abstract: Appendicitis, hypertrophic pyloric stenosis (HPS), and intussusception are common conditions treated in most hospitals. In which hospital settings are children with these conditions treated? Are there differences in outcomes based on hospital characteristics? Our purpose was to use a nationwide database to address these questions. Data were extracted from Kids' Inpatient Database 2000. Data were queried by International Classification of Diseases procedure code for appendectomy and pyloromyotomy and by diagnosis code for intussusception. Length of stay (LOS) and hospital charges were analyzed based on hospital size, location, teaching status, and specialty designation. There were 73,618 appendectomies, with 5,910 (8%) in children's hospitals. Overall LOS was 3.1 days, and was the longest in children's hospitals (3.9). Overall charges were dollar 10,562, with the highest in children's hospitals (dollar 14,124). There were 11,070 pyloromyotomies, with 2,960 (27%) in children's hospitals. Overall LOS was 2.7 days, the shortest being in children's hospitals (2.5). Overall charges were dollar 7,938, with the highest in children's hospitals (dollar 8,676). There were 2,677 intussusceptions, with 921 (34%) in children's hospitals. Overall LOS was 3.0 days, the shortest being in children's hospitals (2.8). Overall charges were dollar 9,558, with the highest in children's hospitals (dollar 10,844). Most children with appendicitis, HPS, and intussusception are treated in nonspecialty hospitals. HPS (27%) and intussusception (34%) are more likely than appendicitis (8%) to be treated in children's hospitals. Children's hospitals have higher charges for all three conditions despite shorter LOS for HPS and intussusception.
authors.affiliation: New Hanover Regional Medical Center, Coastal Area Health Education Center, Wilmington, North Carolina 28402-9025, USA.
authors.forename: Graham H
authors.initials: GH
authors.lastname: Cosper
authors.forename: Mary Sue
authors.initials: MS
authors.lastname: Hamann
authors.forename: Anquonette
authors.initials: A
authors.lastname: Stiles
authors.forename: Don K
authors.initials: DK
authors.lastname: Nakayama
mesh_terms: D001064:Appendicitis / Q000601:surgery; D002648:Child; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D007443:Intussusception / Q000601:surgery; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011707:Pyloric Stenosis / Q000601:surgery; D012424:Rural Population; D014481:United States; D014505:Urban Population