Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

Background: Advances in medicine and changes in the medical environment can affect the diagnosis and treatment of diseases. The main purpose of the present study was toinvestigate whether the difference in accessibility to diagnosis and treatment facilitiesinfluenced the occurrence of appendectomy in Korea.Methods: We collected data on 183,531 appendectomy patients between 2003 and 2017 usingthe National Health Insurance Services claims. Retrospective analysis of relationship betweenthe age-standardized rate (ASR) of appendectomy and clinical variables affecting medicalaccessibility was performed. Pearson’s correlation analyses were used.Results: The incidence of appendectomy decreased from 30,164 cases in 2003 to 7,355 cases in2017. The rate of computerized tomography (CT) scans for diagnosis of appendicitis increasedfrom 4.73% in 2003 to 86.96% in 2017. The ASR of appendectomy in uncomplicated andcomplicated appendicitis decreased from 48.71 in 2005 to 13.40 in 2010 and 8.37 in 2005 to2.96 in 2009, respectively. The ASR of appendectomy was higher in the high-income group.The proportion and ASR of appendectomy in older age group increased steadily with years.The total admission days continued to decrease from 6.02 days in 2003 to 4.96 days in 2017.Conclusion: The incidence of appendectomy was seemingly associated with the rate ofCT scan. In particular, the incidence of appendectomy in uncomplicated appendicitis wasmarkedly reduced.