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Impact of hospital size on the outcomes of appendectomy in children: an analysis of a comprehensive nationwide pediatric dataset

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Abstract

Purposes

The purpose of this study was to investigate the outcomes after appendectomy in children according to hospital size.

Methods

The records of 11,565 patients with the diagnosis-related group code for appendectomy were extracted from HIRA-Pediatric Patient Sample from 2012 to 2016. The number of hospital visits and the length of stay in hospital within 30 days after appendectomy were analyzed.

Results

Patients who were treated at large-sized hospitals were more likely to be younger, more likely to reside in metropolitan areas, and tended to receive laparoscopic surgery. The number of hospital visits within 30 days in patients managed by medium- and large-sized hospitals decreased in comparison to small-sized hospitals. The length of hospital stay in large-sized hospitals was decreased in comparison to small- and medium-sized hospitals. A subgroup analysis revealed that complicated appendectomy did not have a significant impact on the difference in the length of hospital stay between hospital sizes.

Conclusion

The number of hospital visits and the length of hospital stay was higher in small-sized hospitals in comparison to large-sized hospitals. Appendectomy performed in the larger hospital showed better outcomes in pediatric patients. We recommend that pediatric surgical procedures be performed in large hospitals, and that proper incentives be given for procedures to be performed by pediatric specialists.

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Author information

Author notes

  1. Jeik Byun and Jin-Young Min equally contributed this work.

Authors and Affiliations

  1. Department of Pediatric Surgery, Seoul National University Children’s Hospital, Seoul, Korea

    Jeik Byun & Dayoung Ko

  2. Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea

    Jin-Young Min

  3. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

    Hee-Beom Yang

  4. Department of Pediatric Surgery, College of Medicine, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea

    Hyun-Young Kim & Sung Eun Jung

  5. Department of Preventive Medicine, College of Medicine, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea

    Kyoung-Bok Min

Authors
  1. Jeik Byun
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  2. Jin-Young Min
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  3. Hee-Beom Yang
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  4. Dayoung Ko
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  5. Hyun-Young Kim
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Corresponding authors

Correspondence to Hyun-Young Kim or Kyoung-Bok Min.

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The authors declare no conflict of interest in association with the present study.

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Byun, J., Min, JY., Yang, HB. et al. Impact of hospital size on the outcomes of appendectomy in children: an analysis of a comprehensive nationwide pediatric dataset. Surg Today 50, 1515–1523 (2020). https://doi.org/10.1007/s00595-020-02035-1

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  • DOI: https://doi.org/10.1007/s00595-020-02035-1

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