Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Number 5 Jingyuan Road, Shijingshan District, Beijing, 100043, China.
Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Hernia. 2024 Oct;28(5):1969-1978. doi: 10.1007/s10029-024-03138-1. Epub 2024 Aug 23.
Inguinal hernia repair is a common surgical procedure with significant variability in hospitalization costs. Traditional cost analysis methods often overlook the distribution of costs across patient demographics and clinical factors. This study employs a quantile regression model to explore the determinants of hospitalization costs for adult inguinal hernia surgery, providing a detailed understanding of cost variations across different quantiles.
We analyzed data from adult patients who underwent inguinal hernia surgery at Beijing Chaoyang Hospital from January 2015 to June 2023. The study included patient demographics, hernia-related information, surgery-related details, and cost-related data. A quantile regression model was used to assess the impact of various factors on hospitalization costs at different quantiles (10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%). Data were processed using StataSE 15.0 software.
Our study included 16,602 patients, predominantly male (91.86%) and Han Chinese (96.48%), with the 51-64 years age group being the largest (26.80%). The quantile regression analysis revealed significant cost variations across different quantiles. Younger patients incurred higher costs, with age coefficients ranging from -40.541 at the 90th quantile to -3.082 at the 10th quantile. Uninsured patients faced higher costs, with coefficients from 214.747 at the 80th quantile to 501.78 at the 10th quantile. Longer hospital stays correlated with increased costs, with coefficients from 342.15 at the 80th quantile to 405.613 at the 90th quantile. Patients hospitalized multiple times (≥3) had lower costs, with coefficients from -767.353 at the 40th quantile to -311.575 at the 80th quantile. Comorbidities significantly raised costs, with coefficients for three or more comorbidities ranging from 806.122 at the 80th quantile to 1,456.02 at the 40th quantile. Laparoscopic surgery was more expensive than open surgery, with coefficients from 1,834.206 at the 80th quantile to 2,805.281 at the 10th quantile. Bilateral surgeries and the use of biological mesh also resulted in higher costs, with coefficients for bilateral surgeries ranging from 1,067.708 at the 10th quantile to 2,871.126 at the 90th quantile and for biological mesh from 3,221.216 at the 40th quantile to 6,117.598 at the 90th quantile.
Hospitalization costs for inguinal hernia surgery are influenced by multiple factors, with significant variations across different patient groups. Strategies to control costs should be tailored to address the specific needs of patients, optimize surgical methods, and improve perioperative care. Future research should extend these findings across different healthcare settings and consider the latest advancements in medical technology and policy changes.
腹股沟疝修补术是一种常见的外科手术，其住院费用存在显著差异。传统的成本分析方法往往忽略了成本在患者人口统计学和临床因素中的分布。本研究采用分位数回归模型探讨成人腹股沟疝手术住院费用的决定因素，详细了解不同分位数的成本变化。
我们分析了 2015 年 1 月至 2023 年 6 月在北京朝阳医院接受腹股沟疝手术的成年患者数据。研究包括患者人口统计学、疝相关信息、手术相关细节和成本相关数据。使用分位数回归模型评估各种因素对不同分位数（10%、20%、30%、40%、50%、60%、70%、80%、90%）住院费用的影响。使用 StataSE 15.0 软件处理数据。
我们的研究纳入了 16602 名患者，主要为男性（91.86%）和汉族（96.48%），年龄最大的是 51-64 岁（26.80%）。分位数回归分析显示，不同分位数之间存在显著的成本差异。年轻患者的成本更高，年龄系数范围从第 90 分位数的-40.541 到第 10 分位数的-3.082。未参保患者的成本更高，系数范围从第 80 分位数的 214.747 到第 10 分位数的 501.78。住院时间延长与成本增加相关，系数范围从第 80 分位数的 342.15 到第 90 分位数的 405.613。多次住院（≥3 次）的患者成本较低，系数范围从第 40 分位数的-767.353 到第 80 分位数的-311.575。合并症显著增加了成本，三例及以上合并症的系数范围从第 80 分位数的 806.122 到第 40 分位数的 1456.02。腹腔镜手术比开放手术更昂贵，系数范围从第 80 分位数的 1834.206 到第 10 分位数的 2805.281。双侧手术和使用生物网片也导致成本增加，双侧手术的系数范围从第 10 分位数的 1067.708 到第 90 分位数的 2871.126，生物网片的系数范围从第 40 分位数的 3221.216 到第 90 分位数的 6117.598。
腹股沟疝手术的住院费用受多种因素影响，不同患者群体之间存在显著差异。控制成本的策略应根据患者的具体需求进行定制，优化手术方法，并改善围手术期护理。未来的研究应在不同的医疗保健环境中扩展这些发现，并考虑医疗技术的最新进展和政策变化。
