Insurance Status Affects Appendicitis Patients' Risk Of Ruptured Appendix

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Health insurance status, not race, increases an individual's likelihoodof having a perforated appendix, according to a study published in the Journal of the American College of Surgeons, the New York Timesreports. Previous studies had identified race as a factor in the riskof a perforated appendix. The proper treatment for appendicitis issurgery, and the most significant predictor of whether an appendix willrupture is the amount of time before the operation, the Times reports.

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For the study, lead researcher Fredric Pieracci, a surgical resident at the Weill Cornell Medical College,and colleagues examined New York state data from 2003 and 2004 thatincluded 26,637 appendicitis patients. Of those, 7,969 had a perforatedappendix. White, Hispanic, black and Asian-American appendicitispatients had no difference in risk of a ruptured appendix. That findingwas unexpected because data historically have shown that minorities areless likely than others to use health services and be recommended formedical procedures, according to the Times. Researcherssaid their findings should not necessarily be applied to othergeographic locations, but they suggested that the medical community'sawareness of racial inequalities might have resulted in improved carefor minorities.

Researchers did find that patients' insurancecoverage did affect their risk of a ruptured appendix. According to thestudy, Medicaid beneficiaries were 22% more likely than those withprivate insurance to have a perforated appendix, followed by uninsuredpatients at 18% and Medicare beneficiaries at 14%. Pieracci saidresearchers cannot explain the risk differences because the study isretrospective. "But, other studies have identified one of the mainreasons is fear of financial repercussions," he said, adding, "Therecan still be inadequate coverage with public insurance as opposed toprivate insurance" (Bakalar, New York Times, 10/16).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.

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