Trends and outcomes in the utilization of laparoscopic appendectomies in a XXXX in Taiwan from 2003 to 2011.

@entity1 @entity1538 @entity698 @entity37534 @entity6191 @entity258
BACKGROUND: Numerous epidemiological studies have compared outcomes between laparoscopic appendectomies (LA) and @entity1538 ( @entity1538 ); however, few studies have assessed the efficacy of LA specifically in a @entity258 ( @entity258 ). METHODS: We analyzed the trends in the utilization and outcomes of LA versus @entity1538 in an @entity258 in Taiwan using data from the National Health Insurance (NHI) Research Database. RESULTS: Steady temporal growth trends were observed for the @entity1 who underwent LA in both the @entity258 and @entity6191 ( @entity6191 ); however, in each study year, the proportion of @entity258 @entity1 who underwent LA was lower than the proportion of @entity6191 @entity1 who underwent the procedure. The @entity258 @entity1 were more susceptible to payment policies than the @entity6191 @entity1 ; thus, more attention should be paid to vulnerable @entity1 populations when formulating and revising NHI payment policies. Compared with OAs, @entity37534 were associated with a slightly higher rate of routine @entity1 discharges and a lower rate of in-hospital complications (1.48  % vs. 3.76  %, p   <   0.05). The rate of readmission for complications was lower in @entity1 after LA than in @entity1 after @entity1538 (1.64  % vs. 3.89  %, p   <   0.05). The overall case-fatality rate of @entity258 @entity1 who underwent LA was lower than that of those who underwent @entity1538 . LA was correlated with a significantly shorter length of hospital stay (LOS) compared with @entity1538 (3.80        0.08 vs. 5.51        0.11, p   <   0.05). The average hospital cost for LA was slightly less than that for @entity1538 (1178        13 vs. 1191        19 USD, p   <   0.05). A higher percentage of @entity1 who underwent @entity1538 required an LOS longer than 14  days compared to @entity1 who underwent LA (7.73  % vs. 1.97  %, p   <   0.05). Regarding hospital costs and LOS, LA showed significant advantages over @entity1538 in the subpopulations of male @entity1 , @entity1 45  years old and older, @entity1 with Charlson Comorbidity Index (CCI) scores of two or more, and @entity1 with complicated cases of @entity698 . CONCLUSION: The @entity258 @entity1 benefited more from the LA approach than the @entity1538 approach in the treatment of @entity698 , especially regarding LOS, in-hospital complications, in-hospital mortality, and routine discharge rates.
