System dynamics modeling to predict hospitalization costs in adults with inguinal hernia: a single-centre study

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.