APPENDECTOMY. COMPARATIVE STUDY BETWEEN A PUBLIC AND A PRIVATE HOSPITAL

作者：Coelho Julio C U^*; Fernandes Fabiana Marques; Cortiano Luis Gustavo G; de Oliveira Leme Gustavo Munhoz; Sadowski Jose Alfredo; Artner Christian Luiz

来源：Revista da Associacao Medica Brasileira, 2010, 56(5): 522-527.

DOI：10.1590/S0104-42302010000500011

• Socioeconomic factors
• Appendicitis
• Appendectomy
• Health insurance
• Postoperative complications

OBJECTIVE. The aim of this study is to compare data of patients submitted to appendectomy for acute appendicitis at a public hospital and at a private hospital.
METHODS. A total of 200 medical records of patients submitted to appendectomy for acute appendicitis at a public hospital (n = 100) and at a private hospital (n = 100), was reviewed retrospectively.
RESULTS. Mean age and gender distribution were similar for patients of both hospitals. More patients had been previously evaluated by other physicians in the group of the public hospital (n = 85) than of the private hospital (n = 13) (p < 0.0001). Ultrasonography was performed more frequently on patients of the public hospital (n = 56) than of the private hospital (n = 30) (p = 0.0002). Length of hospital stay was longer at the public hospital (3.5 +/- 2.8 days) than at the private hospital (2.5 +/- 1.7 days) (p = 0.0024). Postoperative complications were more frequent at the public hospital (n = 36) than at the private hospital (n = 20) (p < 0.0117). Time to resume routine activities was longer for the public hospital (33.2 +/- 8.3 days) than for the private hospital (16.4 +/- 5.2 days) (p < 0.0001). Multivariate logistic-regression analysis showed that the estimated probability of complicated appendicitis increased with the time interval between onset of symptoms and appendectomy (p < 0.001). Independent risk factor associated with complicated appendicitis was the time interval between onset of symptoms and appendectomy (odds ratio 41.65, 95% CI {confidence interval} 2.90-597.49, p < 0.0001) at the public hospital. There was no independent risk factor associated with complicated appendicitis at the private hospital.
CONCLUSION. There are important differences between public and private hospitals in the diagnosis and outcomes of patients with acute appendicitis submitted to appendectomy.

• 出版日期2010