SP2.1.13Does Health Insurance Status Affect Patient Outcome After Emergency Surgery?

Aim Under the Australian Medicare Scheme, Australian residents are covered for many hospital-related costs. Patients with private insurance presenting with appendicitis can elect to be admitted as a private patient. Despite the stereotypes, little is known on whether the patients’ health cover actually affect clinical outcomes. This study aims to compare the differences in patient outcomes between public and private patients after undergoing operative management for appendicitis. Methods A multi-centre prospectively collected health service database of all appendicectomies performed over a 16-month period was reviewed. In particular, patient demographics, type of operation, primary surgeon, complications and mortality rates were analysed. Results Of the total of 652 patients who underwent an appendicectomy, 203 patients were private, 444 patients were public, and 5 were overseas patients. During the post-operative period, public patients had higher rates of representation to the Emergency Department (ED) for post-operative symptoms (public 12.8% vs private 4.4%, p 0.0007, two-tailed chi square test). In comparison, the rate of post-operative complications with Clavien-Dindo (CD) score ≥ 2 is similar in both groups (p = 0.18, public 4.5% vs private 2%). There were no mortalities recorded for both groups. Conclusion Public patients have higher representation rates to the emergency department after an appendicectomy however post-operative outcomes are similar in both groups in our health system. The difference in complication rates were not significant with both groups recording low complication rates of under 5%.