health education necessary for good appendectomy outcomes:

In a recent article about appendectomies in the province of Manitoba, Canada, the authors looked at the percentage of inflamed appendices that were ruptured at the time of operation. This somewhat obscure data produced somewhat surprising results:

“Total rupture rates were inversely correlated with socioeconomic status; the highest rupture rates occurred in the lowest socioeconomic status groups among both rural and urban residents.”

What surprised me was that in the midst of looking at complications of the most common abdominal surgical procedure done on children, out popped health care inequality due to socioeconomic status as a risk factor for rupture of the appendix.

The authors conclude as follows:
“The study also demonstrates that universal access to healthcare for pediatric patients, which many of us want, will not eliminate healthcare disparities. If we aim to decrease healthcare disparities, we must educate patients and family members about how and when to access the healthcare system.”

Sobering. There’s clearly more to effective health care reform than universal access. The role of education in improving our health care system and reducing health disparities cannot be over sold. Let’s hope that this part of health care reform continues to pop up on agendas all over Washington DC in the coming months.

The IMH will sponsor the Friday Medical Conference talk on healthcare inequalities at St. Patrick Hospital on 4/17/09 during April is Ethics Month, with Dr. John Stone. John Stone, MD,PhD is a faculty member of the Center for Health Policy and Ethics at Creighton University School of Medicine, and one of the original founders of the Institute of Medicine and Humanities in Missoula.

Hope to see you there – 4/17/09 7:30am @SPH conference center.

Bratu I et al. Pediatric appendicitis rupture rate: Disparities despite universal health care. J Pediatr Surg 2008 Nov; 43:1964.


About imh4msla

Dr Schlesinger is an adult and pediatric rheumatologist in Missoula. She was an IMH board member for a few years before assuming the director position in January 2007 when Dr Herbert Swick retired. As IMH director, she promotes collaborative models of care within the hospital, and explores new approaches to teaching the collaborative model to health careers students at the University of Montana. Dr Schlesinger is the track director for the WWAMI program, helping medical students from the University of Washington School of Medicine learn clinical medicine in Missoula.
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