title: Management and outcomes for children with acute appendicitis differ by hospital type: areas for improvement at public hospitals.
abstract: BACKGROUND
  Access to health care is a well-recognized issue in health policy, but use once patients have entered the health care system is uncommonly addressed.
  
  
  METHODS
  We performed a retrospective review of children between 2 and 17 years of age with pathologically confirmed appendicitis at our public city hospital and private university hospital and compared management and outcomes.
  
  
  RESULTS
  Among patients with acute appendicitis, the median length of stay was a day longer in the public hospital (2 days vs 1 day, P = <.001) despite a similar complication rate (12% vs 11%). More computed tomography (CT) scans were performed at the public hospital (36% vs 21%, P = .02) with a trend toward less use of ultrasound (US) (54% vs 65%, P = .13).
  
  
  CONCLUSIONS
  Children at the public city hospital have a longer length of stay and undergo more expensive imaging. These findings may provide areas for improvement to optimize the care of children with appendicitis at government-funded institutions.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, New York, New York, USA.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Zilbert
authors.forename: Emily F
authors.initials: EF
authors.lastname: Stamell
authors.forename: Isaac
authors.initials: I
authors.lastname: Ezon
authors.forename: Avi
authors.initials: A
authors.lastname: Schlager
authors.forename: Howard B
authors.initials: HB
authors.lastname: Ginsburg
authors.forename: Evan P
authors.initials: EP
authors.lastname: Nadler
mesh_terms: D000293:Adolescent; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003952:Diagnostic Imaging; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D016304:Hospitals, Private; D006779:Hospitals, Public; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D012959:Socioeconomic Factors