Because there is conflicting evidence regarding the benefits of laparoscopic appendectomy, we hypothesized that there would be measurable differences in its use among various socioeconomic groups and geographic areas.

The Nationwide Inpatient Sample was queried for appendectomies performed between the years of 1997 and 2003. Rates of laparoscopic appendectomy were compared among hospital subtypes and demographic groups.

The percentage of appendectomies performed laparoscopically has increased from 19.1% in 1997 to 37.9% in 2003. Only 11.8% of cases of complicated appendicitis were treated laparoscopically in 1997, compared with 23.5% in 2003. Nonwhite patients and those from low-income areas continue to be less likely to undergo laparoscopic appendectomy (P < .001).

Our analysis indicates that despite expanding use of laparoscopic appendectomy nationwide, patients who live in zip codes areas with a preponderance of minorities or low-income earners are more likely to have open appendectomy.