Abstract
Objective
We sought to identify barriers and delays in care associated with the increased prevalence
of perforated appendicitis among Colorado's pediatric Medicaid population.
Methods
We conducted a retrospective cohort study of all cases of pediatric appendicitis,
which had Colorado Medicaid from 2007 to 2008 using descriptive statistics, bivariate
analysis, and multivariable logistic regression.
Results
Of the 479 appendicitis cases, 42.6% were perforated. In both the bivariate and multivariate
analysis, perforated cases did not significantly differ from nonperforated cases with
respect to sex, rurality of residence, or race with the exception of black race in
the multivariate model. Perforated cases were more likely to be younger, have been
enrolled in Medicaid for less than 6 months, have seen a provider within 5 days of
their diagnosis, and have been transferred to another hospital for treatment.
Conclusions
The high prevalence of perforated appendicitis in Colorado children with Medicaid
coverage is not associated with race or physical proximity to care but may be associated
with the duration of Medicaid coverage, which highlights the importance of establishing
medical homes to direct patients on where and how to seek care.
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Article Info
Publication History
Published online: January 23, 2013
Accepted:
September 10,
2012
Received in revised form:
September 9,
2012
Received:
August 17,
2012
Footnotes
☆Funding sources/disclosures: N/A.
☆☆Prior presentations: Poster Presentation at 2011 American College of Emergency Physicians Scientific Assembly.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
