[Costs of appendicitis treatment by diagnosis-related groups in a third-level pediatric hospital].
BACKGROUND
Diagnosis-related groups (DRGs) are widely used in Europe. They allow performing comparisons in hospitals and incurrent hospital payment systems, defining the payment categories. We undertook this study to classify children who underwent appendectomy according to DRGs.


METHODS
Cross-sectional study. Comorbidities, length of hospitalization, histopathologic classification, and DRG classifications were analyzed.


RESULTS
We included 313 patients, 62% males, with an average age of 8 ± 3 years; 91% were referred by another hospital and 67% were treated at night. Average length of hospitalization was 4 ± 3 days. There were comorbidities in 8% and surgical complications in 11%. According to histopathology, appendicitis was edematous (11%), suppurative (36%), gangrenous (22%), perforated (29%), and abscessed (2%). At discharge, 97% of the patients were healthy. Total cost for DRG 343 was $10,470,173.00 (Mexican pesos), DRG 342 was $1,227,592.00 and DRG 340 was $511,521.00. The global amount was $12,209,286.00 (Mexican pesos).


CONCLUSIONS
The unitary cost for treatment of appendectomy for DRG 343 was $37,935.00, for DRG 342 was $49,103.00 and for DRG 340 was $42,626.00 (Mexican pesos). Because 88% of the cases of appendicitis were uncomplicated, this amount of money could be spent to treat these patients in a second-level hospital, using reimbursement 343 without generating additional expenses.
Dirección de Educación e Investigación en Salud, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico. albtlacuilo@yahoo.com.
Alberto
A
Tlacuilo-Parra
Departamento de Cirugía Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
Araceli
A
Hernández-Hernández
Departamento de Anatomía Patológica, UMAE Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
Martha
M
Venegas-Dávalos
Dirección de Educación e Investigación en Salud, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
Violeta
V
Gutiérrez-Hermosillo
Dirección de Educación e Investigación en Salud, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
Elizabeth
E
Guevara-Gutiérrez
Departamento de Cirugía Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
Gabriela
G
Ambriz-González
D001062:Appendectomy / Q000191:economics*; D001064:Appendicitis / Q000191:economics* / Q000601:surgery*; D002648:Child; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D062606:Tertiary Care Centers
Appendicitis; análisis de costos; apendicectomía; appendectomy; cost analyses; diagnosis-related groups; economics; economía; grupos relacionados con el diagnóstico; pediatric population; pediatría