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Regular visits to PCP may reduce risk for acute appendicitis

Mehul V. Raval

Children and adolescents with health insurance who regularly saw their primary care physician were less likely to have a ruptured appendix, according to findings recently published in JAMA Surgery.

“Within the world of medicine, we have been very focused on improving access to health care by making sure patients have insurance and are able to seek medical attention when needed, Mehul V. Raval, MD, MS, FACS, FAAP, director, Center for Clinical Outcomes Research and Public Health at Emory University School of Medicine, told Healio Family Medicine. “In this study we take things one step further by not just looking at access to care but actual utilization of care.”

The researchers identified 38,348 children with appendicitis, and the analysis included the 19,109who had continuous health insurance throughout the study period. Of these children, 5,509 presented with ruptured appendixes.

Raval and colleagues found that children who had a ruptured appendix were less likely to have used outpatient health care in the 12 months prior to diagnosis vs. those with acute appendicitis (82.7% vs. 87.8%; P <.001). In addition, after adjusting data for type of insurance, geographical area, gastrointestinal comorbidities, income, sex and age, use of outpatient health care prior to presentation was linked to lower odds for a ruptured appendix (OR = 0.63; 95% CI, 0.58-0.69). This link grew stronger as the number of visits increased 12 months before presentation (OR = 0.86; 95% CI, 0.77-0.95 for 1 to 2 visits; OR = 0.61; 95% CI, 0.55-0.67 for 3 to 6 visits; and OR = 0.43; 95% CI, 0.38-0.48 for 7 or more visits in patients ages 5 to 18 years).

“We have always understood that having a great relationship with your primary care physician is important for your health, but we have not typically tied that relationship to surgical outcomes,” Raval said in the interview. “For many adults [with conditions] such as heart failure and long-term diabetes management, we know that [such] patients who utilize care appropriately and make their appointments regularly are going to have better long-term outcomes. This [study] illustrates this phenomenon in children and for a more acute condition.”

Children and adolescents with health insurance who regularly saw their primary care physician were less likely to have a ruptured appendix, according to findings recently published in JAMA Surgery.

Source: Shutterstock.

Raval said he is looking into other ways the “close-knit relationship” among PCPs and patients can enhance care during various surgeries, adding that the current study’s results provide another reason for PCPs to ensure their patients stay in touch.

“The relationships between patients and their primary care providers are so valuable,” he said. “That relationship is a gauge of how patients interact with the health care system and may facilitate when patients seek care for acute conditions (such as appendicitis).”– by Janel Miller