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Age-Dependent Costs and Complications in Pediatric Umbilical Hernia Repair

Jonathan E Kohler1, Randi S Cartmill1, Dou-Yan Yang2

  • 1Wisconsin Surgical Outcomes Research Program, University of Wisconsin - Madison, Madison, WI; Department of Surgery, University of Wisconsin - Madison, Madison, WI.

The Journal of Pediatrics
|July 7, 2020
PubMed

Insights

Umbilical hernia repair in young children shows significant regional variation. Early repair (under age 2) is linked to higher costs and increased hospitalizations and emergency visits.

Area of Science:

  • Pediatric Surgery
  • Health Services Research
  • Healthcare Economics

Background:

  • Umbilical hernia repair is a common pediatric surgical procedure.
  • Regional variations in surgical practice and associated costs are not well characterized.
  • Understanding age-related outcomes is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

  • To analyze regional differences in the age of patients undergoing umbilical hernia repair.
  • To determine the impact of repair age on healthcare costs and subsequent patient care.
  • To identify potential disparities in pediatric surgical care for umbilical hernias.

Main Methods:

  • A cross-sectional descriptive study utilized US employer-based insurance claims from July 2012 to December 2015.
  • Identified 5212 children (<18 years) undergoing uncomplicated umbilical hernia repair as an isolated procedure.
  • Analyzed data based on patient age (younger than 2 years vs. older) and geographic census region.

Main Results:

  • Children under 2 years accounted for 9.7% of repairs, with significant regional variation (6%-14%, P < .001).
  • Average total payments were higher for younger children ($8219) compared to older children ($6137).
  • Postoperative admissions (73.1 vs. 7.43 per 1000) and ED visits (41.5 vs. 15.9 per 1000) were significantly higher for children under 2 years.

Conclusions:

  • Umbilical hernia repairs are frequently performed at early ages, exhibiting considerable regional variability.
  • Repairing umbilical hernias in children younger than 2 years is associated with increased healthcare costs.
  • Early repair in this age group correlates with a higher incidence of postoperative hospitalizations and emergency department visits.
Abstract

Keywords:
herniorrhaphypediatric surgerysurgical costssurgical outcomes

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