Submitting/Presenting Author

Neal TalukdarFollow

Abstract Type

Research

Primary Mentor

Tolulope Oyetunji, MD

Start Date

10-5-2021 11:30 AM

End Date

10-5-2021 1:30 PM

Presentation Type

Poster Presentation

Description

Background + Objectives/Goal: Racial demographic and health care coverage impact how and when patients seek care. Previous studies have documented that minority children present with higher rates of perforated appendicitis. We aimed to identify if racial and coverage disparities were associated with the timing and mechanism of appendicitis presentation.

Methods/Design: We performed a prospective study of children (≤ 18 years old) who underwent laparoscopic appendectomy from May 2018 - September 2020. Prior to discharge, the patient’s parent/guardian completed a survey focused on health care encounters within the past year. Surveys were collected using RedCap®; data were analyzed using STATA®.

Results: In total, 178 patients completed the questionnaire. The median age at appendectomy was 11 years (IQR 8, 14); 67.4% were Caucasian, 14.0% Hispanic, 9.0% African American (AA), and 5.1% identified as multiracial. More Hispanics presented with perforated appendicitis (68% vs 22-27.5% for other groups, p=0.02). We then performed a sub-analysis of survey data from patients with perforated appendicitis (n=68) to identify factors associated with this difference. A far greater percentage of AA, Hispanic, and multiracial patients had Medicaid insurance (p<0.001). All minority ethnicities were more likely to have been previously seen in the emergency room (ER) for their current symptoms prior to diagnosis than Caucasians (p=0.01, Table 1). More AAs and Hispanics also utilized the ER 2+ times in the past year (p=0.01); however, there was no difference among groups in the ability to find a child provider (p=0.66) or being able to afford a child’s medications (p=0.99).

Conclusions: A greater percentage of Hispanic and AA patients utilized the ER multiple times in the year before being diagnosed with appendicitis, including been seen in the ER more than once for their appendicitis symptoms. Further studies are needed to help mitigate these missed opportunities and improve efficient health care utilization.

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May 10th, 11:30 AM May 10th, 1:30 PM

Does Access to Care Influence a Child’s Presentation with Appendicitis?

Background + Objectives/Goal: Racial demographic and health care coverage impact how and when patients seek care. Previous studies have documented that minority children present with higher rates of perforated appendicitis. We aimed to identify if racial and coverage disparities were associated with the timing and mechanism of appendicitis presentation.

Methods/Design: We performed a prospective study of children (≤ 18 years old) who underwent laparoscopic appendectomy from May 2018 - September 2020. Prior to discharge, the patient’s parent/guardian completed a survey focused on health care encounters within the past year. Surveys were collected using RedCap®; data were analyzed using STATA®.

Results: In total, 178 patients completed the questionnaire. The median age at appendectomy was 11 years (IQR 8, 14); 67.4% were Caucasian, 14.0% Hispanic, 9.0% African American (AA), and 5.1% identified as multiracial. More Hispanics presented with perforated appendicitis (68% vs 22-27.5% for other groups, p=0.02). We then performed a sub-analysis of survey data from patients with perforated appendicitis (n=68) to identify factors associated with this difference. A far greater percentage of AA, Hispanic, and multiracial patients had Medicaid insurance (p<0.001). All minority ethnicities were more likely to have been previously seen in the emergency room (ER) for their current symptoms prior to diagnosis than Caucasians (p=0.01, Table 1). More AAs and Hispanics also utilized the ER 2+ times in the past year (p=0.01); however, there was no difference among groups in the ability to find a child provider (p=0.66) or being able to afford a child’s medications (p=0.99).

Conclusions: A greater percentage of Hispanic and AA patients utilized the ER multiple times in the year before being diagnosed with appendicitis, including been seen in the ER more than once for their appendicitis symptoms. Further studies are needed to help mitigate these missed opportunities and improve efficient health care utilization.