Tong Deyu, Liu Xiaoli, Shen Yingmo
Beijing Chaoyang Hospital, Capital Medical University, Shijingshan District, Beijing, 100043, China.
Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Number 5 Jingyuan Road, Shijingshan District, Beijing, 100043, China.
Hernia. 2025 May 3;29(1):157. doi: 10.1007/s10029-025-03348-1.
This research aims to develop a novel methodology and provide innovative insights for accurately forecasting hospitalization expenses by developing an appropriate system dynamics model to predict hospital costs and simulate future trends. The findings are meant to serve as a guide for creating effective policies and measures to curb the growth in hospitalization costs.
We selected adults who had inguinal hernia surgery at Beijing Chaoyang Hospital from January 2015 to December 2023 according to the inclusion and exclusion criteria. We identified the primary factors that influence hospitalization costs and conceptualized them as interconnected subsystems within the broader hospitalization cost system. We develop a system dynamics model of hospitalization costs using the stock-flow tree modeling framework based on flow-rate variables.
This study included a total of 23,696 adult patients who had inguinal hernia surgery. The simulation results for the period 2016 to 2033 were generated by running the model in Vensim simulation software. The forecast for 2033 predicts that hospitalization costs for adult inguinal hernia patients at Beijing Chaoyang Hospital will reach 81.28 million RMB. The number of surgeries will rise to 7,913, with 65% (5,104 surgeries) being outpatient procedures. The average cost per hospitalization will be 10,271.35 RMB. The elderly population among surgical patients is expected to increase to 5,323. For every 1,000 laparoscopic surgeries, 454 will be performed. For every 1,000 surgeries, 437 will involve the use of degradable mesh implants. The number of patients with severe comorbidities is expected to reach 6,403, and medication costs are forecasted to be 1.44 million RMB.
The system dynamics model for hospitalization costs effectively captures the relationships between multiple influencing factors and hospital expenses. The model's reliability and predictive results' credibility are indicated by the high alignment between simulated historical data and actual historical values. Hospitalization costs are projected to increase annually, while per capita hospitalization costs are expected to decrease. Factors such as an aging population, improved cost control policies, and the promotion of outpatient surgeries exert significant influence in this trend.
本研究旨在开发一种新方法，并通过构建合适的系统动力学模型来预测医院成本和模拟未来趋势，从而为准确预测住院费用提供创新性见解。研究结果旨在为制定有效政策和措施以遏制住院费用增长提供指导。
我们根据纳入和排除标准，选取了2015年1月至2023年12月在北京朝阳医院接受腹股沟疝手术的成年人。我们确定了影响住院费用的主要因素，并将其概念化为更广泛的住院费用系统内相互关联的子系统。我们使用基于流量变量的存量-流量树建模框架开发了住院费用的系统动力学模型。
本研究共纳入23,696例接受腹股沟疝手术的成年患者。2016年至2033年期间的模拟结果是通过在Vensim模拟软件中运行该模型生成的。对2033年的预测表明，北京朝阳医院成年腹股沟疝患者的住院费用将达到8128万元人民币。手术数量将增至7913例，其中65%（5104例手术）为门诊手术。每次住院的平均费用将为10271.35元人民币。手术患者中的老年人口预计将增至5323人。每1000例腹腔镜手术中，将有454例进行。每1000例手术中，437例将使用可降解网状植入物。患有严重合并症的患者数量预计将达到6403人，药品费用预计为144万元人民币。
住院费用的系统动力学模型有效地捕捉了多个影响因素与医院费用之间的关系。模拟历史数据与实际历史值之间的高度一致性表明了该模型的可靠性和预测结果的可信度。预计住院费用将逐年增加，而人均住院费用预计将下降。人口老龄化、成本控制政策的改善以及门诊手术的推广等因素在这一趋势中发挥着重要影响。
