Cost effectiveness of the quality assurance and performance improvement project for suspected appendicitis study

Abstract Introduction Appendicitis is the most common pediatric emergent surgical condition, with 77,000 American pediatric admissions costing $680 million US annually. Diagnosing appendicitis can be challenging. The prospective Quality Assurance and performance improvement project for suspected aPPEndicitis (QAPPE) study implemented a standardized appendicitis assessment pathway. This current study aims to assess the cost-effectiveness of the QAPPE pathway. Methods QAPPE data (February 2018–January 2019) were compared to retrospective data from the year prior (January–December 2017). Patients aged Results QAPPE (n = 247) and traditional care (n = 234) patient were compared. Traditional care had higher admission frequency and lower pediatric appendicitis score. Demographics between groups were similar overall and for those admitted. Patient costs were $3656.32 (95% CI $2407–$5250) Canadian (CAD) for QAPPE and $3823.56 (95% CI $2604.74–$5451) CAD for traditional care. QAPPE was the dominant strategy in the base model and probabilistic simulation found it favored in 64.7% of model iterations with a willingness to pay of $70,000 CAD. Conclusion Using the QAPPE pathway to assess patients with suspected appendicitis reduced costs and improved effectiveness of patient care. Level of evidence 2.