Health insurance status, not race, increases an individual's likelihood of having a perforated appendix, according to a study published in the Journal of the American College of Surgeons, the New York Times reports.
Previous studies had identified race as a factor in the risk of a perforated appendix. The proper treatment for appendicitis is surgery, and the most significant predictor of whether an appendix will rupture is the amount of time before the operation, the Times reports.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 that included 26,637 appendicitis patients. Of those, 7,969 had a perforated appendix.
White, Hispanic, black and Asian-American appendicitis patients had no difference in risk of a ruptured appendix. That finding was unexpected because data historically have shown that minorities are less likely than others to use health services and be recommended for medical procedures, according to the Times.
Researchers said their findings should not necessarily be applied to other geographic locations, but they suggested that the medical community's awareness of racial inequalities might have resulted in improved care for minorities.
Researchers did find that patients' insurance coverage did affect their risk of a ruptured appendix. According to the study, Medicaid beneficiaries were 22% more likely than those with private insurance to have a perforated appendix, followed by uninsured patients at 18% and Medicare beneficiaries at 14%.
Pieracci said researchers cannot explain the risk differences because the study is retrospective. "But, other studies have identified one of the main reasons is fear of financial repercussions," he said, adding, "There can still be inadequate coverage with public insurance as opposed to private insurance".
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