Same-Day Versus Next-Day Discharge After Laparoscopic Appendectomy for Uncomplicated Appendicitis in Children: A Propensity Score-Matched Cost Analysis.

BACKGROUND

Same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis has been proposed as a strategy to reduce hospital costs without compromising safety, but evidence in pediatric patients remains limited.

METHODS

We conducted a retrospective study of pediatric patients undergoing laparoscopic appendectomy for uncomplicated appendicitis, comparing same-day and next-day discharge. Baseline differences were addressed using 1:2 propensity score matching. Costs were analyzed using linear regression with cluster-robust standard errors, and inverse probability of treatment weighting was used as a sensitivity analysis.

RESULTS

Among 102 patients (37 same-day discharge and 65 delayed discharge), 28 same-day discharge patients were matched to 36 delayed-discharge controls. Same-day discharge was associated with a mean reduction in total cost of €319.9 (95% CI: -€413.6 to -€226.2; p < 0.0001), mainly explained by lower admission-related costs, with no significant difference in outpatient consultation costs. Sensitivity analysis using inverse probability weighting in the full cohort showed a similar estimate (-€311.7; 95% CI: -€421.1 to -€202.3; p < 0.0001). Complications were rare and similar in both groups (1/28 vs. 1/36), which limited formal comparison of complication risk.

CONCLUSIONS

Same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis was associated with lower healthcare costs, largely due to reduced admission-related costs, with no apparent signal of increased complications.