Does access to care affect outcomes of appendicitis in children? - a population-based cohort study

Table 1 Sex-adjusted appendectomy rates per 100,000 children in the population less than nineteen years of age by district health council (DHC) of patient residence in Ontario, fiscal 1993-2000

District Health Council (DHC)	Percent Rural	Positive Appendectomy		Negative Appendectomy		Perforated Appendicitis
		Number of Appendectomy Per Year †	Sex- Adjusted Rate ‡	Number of Appendectomy Per Year †	Sex- Adjusted Rate ‡	Number of Appendectomy Per Year †	Sex- Adjusted Rate ‡
sorted by ascending rank order of rural to urban)
Grey, Bruce, Huron, Perth	82	84.4	102.2	14.3	17.1	30.3	36.9
Muskoka, Nipissing, Parry Sound & Timiskaming	74	70.4	122.6*	15.0	26.0***	23.3	40.8
Quinte, Kingston, Rideau	39	133.0	107.8	15.6	12.3	15.6	29.5
Algoma, Cochrane, Manitoulin & Sudbury	37	115.9	98.4	16.1	13.6	36.9	31.8
Grand River	32	75.9	115.4	12.4	18.7	24.5	37.5
Northwestern Ontario	29	80.3	112.0	12.3	17.1	27.3	38.2
Waterloo Region-Wellington-Dufferin	23	186.8	106.0	32.4	18.4	65.8	37.3
Thames Valley	23	142.6	91.9	22.0	14.2	50.4	32.5
Essex, Kent, and Lambton	20	142.5	87.3	15.0	9.1	39.5	24.4
Durham, Haliburton, Kawartha & Pine Ridge	19	236.9	110.5**	47.1	22.2***	76.4	35.7
Champlain	16	262.0	100.5	24.8	9.5	78.6	30.1
Simcoe-York	9	243.6	88.3	32.4	11.7	93.4	33.7
Niagara Region	3	77.5	74.5*	12.8	12.3	24.4	23.6
Halton-Peel	0	283.3	83.2	38.0	11.1	95.6	28.0
Hamilton-Wentworth	0	96.6	80.4	8.3	6.8	38.0	31.6
Metropolitan Toronto	0	427.5	81.4**	59.1	11.3	152.0	28.9
Province-wide Age and Sex Adjusted Rate			93.20		13.19		31.29
*SMALL AREA VARIATION SUMMARY STATISTICS*
Extremal Quotient [EQ]			1.65		3.80		1.73
Ratio of Third Quartile over First Quartile			1.28		1.59		1.27
Coefficient of Variation			13.09		32.04		12.95
Systematic Component of Variation			15.63		87.74		-0.10

† Average over time period
‡ Rate per 100,000
* p < 0.05; ** p < 0.01; *** p < 0.001
The p-values are based on the 1 degree of freedom chi-square test for the difference in appendectomy rates between each DHC and the province-wide rate.

ISSN: 1472-6963