Author Affiliation: Länssjukhuset Ryhov, Jönköping, Sweden.
In their analysis of the quality of the health care system in US counties, Camp et al1 analyzed the proportion of cases of perforated appendicitis in children as a measure of the quality of surgical care and found that counties with the highest density of pediatricians had the lowest proportion of perforations. No association was found for other providers or health care facility factors.
Andersson RE. Proportion of Cases of Perforated Appendicitis: A Bad Measure of Quality of Care. Arch Surg. 2011;146(7):885-886. doi:10.1001/archsurg.2011.168