Despite unparalleled advances in perioperative medicine, surgical outcomes remain poor for racial minority patients relative to their white counterparts. Little is known about the excess costs to the health care system related to these disparities.

We performed a retrospective analysis of data from the Nationwide Inpatient Sample between 2001 and 2018. We included children younger than 18 years admitted with appendicitis who underwent an appendectomy during their hospital stay. We examined the inflation-adjusted hospital costs attributable to the racial disparities in surgical complications and perforation status, focusing on differences between non-Hispanic white patients and non-Hispanic Black patients.

We included 100 639 children who underwent appendectomy, of whom 89.9% were non-Hispanic white and 10.1% were non-Hispanic Black. Irrespective of perforation status at presentation, surgical complications were consistently higher for Black compared with white children, with no evidence of narrowing of the racial disparity gap over time. Black children consistently incurred higher hospital costs (median difference: $629 [95% confidence interval: $500–$758; P < .01). The total inflation-adjusted hospital costs for Black children were $518 658 984, and $59 372 044 (11.41%) represented the excess because of the racial disparities in perforation rates.

Although all patients had a progressive decline in post appendectomy complications, Black children consistently had higher rates of complications and perforation, imposing a significant economic burden. We provide an empirical economic argument for sustained efforts to reduce racial disparities in pediatric surgical outcomes, notwithstanding that eliminating these disparities is simply the right thing to do.

尽管围手术期医学取得了无与伦比的进步，但与白人相比，少数族裔患者的手术结果仍然很差。人们对与这些差异相关的医疗保健系统的超额成本知之甚少。

我们对 2001 年至 2018 年间全国住院患者样本的数据进行了回顾性分析。我们纳入了因阑尾炎入院且在住院期间接受阑尾切除术的 18 岁以下儿童。我们检查了因手术并发症和穿孔状态的种族差异而导致的通货膨胀调整后的医院成本，重点关注非西班牙裔白人患者和非西班牙裔黑人患者之间的差异。

我们纳入了 100 639 名接受阑尾切除术的儿童，其中 89.9% 为非西班牙裔白人，10.1% 为非西班牙裔黑人。无论就诊时的穿孔状态如何，与白人儿童相比，黑人儿童的手术并发症始终较高，没有证据表明种族差异差距随着时间的推移而缩小。黑人儿童的住院费用一直较高（中位数差异：629 美元 [95% 置信区间：500-758 美元；P < .01）。黑人儿童经通货膨胀调整后的住院总费用为 518 658 984 美元，其中 59 372 044 美元（11.41%）代表因穿孔率的种族差异而导致的超额部分。

尽管所有患者的阑尾切除术后并发症均逐渐减少，但黑人儿童的并发症和穿孔率始终较高，造成了重大的经济负担。我们为持续努力减少儿科手术结果中的种族差异提供了实证经济论据，尽管消除这些差异是正确的做法。