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Study comparing the cost of primary and delayed surgery for appendicular masses and abscesses

C. Raquillet, T. Blanc, E. Carricaburu, A. Paye-Jaouen, A. El Ghoneimi, A. Bonnard

Robert Debré Hospital, Paris, France



Introduction: The medical benefits of the delayed management of appendicular abscesses and masses are well known. We sought to assess its economic impact.

Material and methods: We compared a group of patients with complicated appendicitis treated by delayed surgery (Group 1) with a retrospective series of patients with the same diagnosis operated on immediately (Group 2). In Group 1, patients were treated by intravenous antibiotic therapy and had appendicectomy during the second hospitalization. The costs incurred in Robert Debré hospital, according to the method NSC (National Scale of Costs) taking into account the direct and indirect costs for HGP (homogenous group of patients) were studied. The revenue for the hospital was calculated on the price of HGP concerned. Each group contains 10 children. In addition, the durations of hospitalization and complications for these 2 groups were taken into account.

Results: The costs found were 5552 euros (medical and surgical HGP, for Group 1 patients and 4900 euros for the patients in Group 2.The 2008 rate for surgical HGP in the group operated immediately (Group 2) is 3366 euros. The delayed surgery group (Group 1), which combines a medical HGP to a surgical HGP is at 4022 euros. The average duration of hospitalization was 6.5 days for Group 1 (including the 2 hospitalizations) and 12.7 days for Group 2. There were no complications in the delayed surgery group and in the group of immediate surgery. Conclusions: At the time when economic logic could guide the treatment modalities, it is necessary to defend the interests of medical management which seems to be more expensive.


Key words: appendicular mass, appendicular abscess, cost.