Epidemiology of appendicitis and appendectomy for the low-income population in Taiwan, 2003–2011

BMC Gastroenterology

Research Article

Robert K Lai¹  Yuan-Hung Liu²  Chien-Lung Chan³  Ren-Hao Pan⁴  Nan-Ping Yang⁵  Shun-Zhi Zhu⁶  Kai-Biao Lin⁷ 

[1] Department of Computer Science and Engineering, Yuan Ze University, 32003, Taoyuan, Taiwan;Innovation Center for Big data and Digital Convergence, Yuan Ze University, 32003, Taoyuan, Taiwan;Department of Computer Science and Engineering, Yuan Ze University, 32003, Taoyuan, Taiwan;Innovation Center for Big data and Digital Convergence, Yuan Ze University, 32003, Taoyuan, Taiwan;Section of Cardiology, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan;Department of Information Management, Yuan Ze University, 32003, Taoyuan, Taiwan;Innovation Center for Big data and Digital Convergence, Yuan Ze University, 32003, Taoyuan, Taiwan;Innovation Center for Big data and Digital Convergence, Yuan Ze University, 32003, Taoyuan, Taiwan;Management Center, Keelung Hospital, Ministry of Health and Welfare, Keelung City, Taiwan;Institute of Public Health, National Yang-Ming University, Taipei, Taiwan;School of Computer & Information Engineering, Xiamen University of Technology, 361024, Xiamen, China;School of Computer & Information Engineering, Xiamen University of Technology, 361024, Xiamen, China;Department of Computer Science and Engineering, Yuan Ze University, 32003, Taoyuan, Taiwan;

关键词: Appendicitis;    Appendectomy;    Epidemiology;    Low-income population;    Socioeconomic status;   

DOI  :  10.1186/s12876-015-0242-1

 received in 2014-10-13, accepted in 2015-01-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAlthough numerous epidemiological studies on appendicitis have been conducted worldwide, only a few studies have paid attention to the effect of socioeconomic status on appendicitis, particularly studies focusing on the low-income population (LIP).MethodsWe analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance Research Database from 2003 to 2011. All cases diagnosed as appendicitis were enrolled.ResultsBetween 2003 and 2011, 2,916 patients from the LIP and 209,206 patients from the normal population (NP) were diagnosed with appendicitis. Our finding revealed that the ratios of comorbidities, complicated appendicitis, and readmissions in LIP patients were slightly higher than those of NP patients. LIP patients were more likely to live in suburban and rural areas, and hence a higher proportion of them were hospitalized in a district or regional hospital compared with NP patients. The crucially finding was that the overall incidence ratios of appendicitis, acute appendicitis, and perforated appendicitis in the LIP were substantially higher than those in the NP (36.25%, 35.33%, and 37.28%, respectively). The mean LOS in LIP patients was longer than that of NP patients. The overall case-fatality ratio of appendectomy in the LIP was higher when compared with the NP (0.41% versus 0.12%, p < 0.05). We also observed that appendicitis was occurred frequently in male patients, with a higher incidence for those aged 15–29 years in both the LIP and NP. The incidences of incidental appendectomy showed a decreasing trend in both the LIP and NP. Finally, a valuable discovery was that the total hospital cost was comparable between the laparoscopic appendectomy (LA) and open appendectomy (OA) (1,178 ± 13 USD versus 1,191 ± 19 USD, p < 0.05) in LIP patients because they saved more hospitalization costs than NP patients when the previous one chose the LA.ConclusionThis study confirmed that a lower socioeconomic status has significantly negative impact on the occurrence and treatment of appendicitis and appendectomy. In terms of hospital costs and LOS, LIP patients benefit more from the LA approach than they do from the OA approach in the treatment of appendicitis.

【 授权许可】

Unknown   
© Lin et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.