[Trends in adenoidectomy in children in Beijing tertiary hospitals from 2013 to 2022]

To examine the evolution of surgical techniques and trends in overall inpatient burden for pediatric adenoidectomy in Beijing tertiary hospitals from 2013 to 2022. A retrospective observational study was conducted using the regional health information platform of Beijing. Data from children aged ≤14 years who underwent adenoidectomy between 2013 and 2022 were extracted, including total hospitalization cost, length of stay(LOS), surgical material cost, surgical fee, operative technique, perioperative antimicrobial drugs cost, coagulation factor cost, and blood transfusion cost. The Mann-Kendall trend test was used to assess temporal changes in total hospitalization expenses and the structure of cost components. The results showed that over the 10-year period from 2013 to 2022, a total of 25 989 children underwent adenoidectomy in tertiary hospitals. The proportion of children aged ≤6 years increased from 59.83% to 76.11%, showing a significant upward trend (Z=2.15, P=0.032). Only one case required surgical hemostasis due to postoperative bleeding. During the ten-year period, the median hospitalization cost for adenoidectomy in tertiary hospitals was ¥12 425.82 (¥11 307.43, ¥14 955.42).Overall hospitalization cost demonstrated a fluctuating downward pattern, decreasing from ¥15 229.73 in 2013 to ¥13 927.52 in 2022, this declining trend was not statistically significant(Z=-0.54, P=0.592). In contrast, the surgical costs showed an upward trend over the decade increasing from ¥1 856.22 in 2013 to ¥3 726.45 in 2022, which was statistically significant (Z=3.22, P=0.001), while the cost of surgical materials showed no significant increase (Z=1.79, P=0.074).Concurrently, the average LOS decreased remarkably from 10.56 days in 2013 to 3.26 days in 2022 (Z=-3.94, P<0.001). The cost of perioperative antimicrobial drugs decreased (Z=-3.94, P<0.001), while the cost of coagulation factors and blood transfusion remained unchanged (Z=0.54, P=0.592;Z=0.56, P=0.578). Comparison between 2013-2017 and 2018-2022 showed a significant increase in the use of coblation from 28.9% to 42.5% (χ²=638.7, P<0.001).Furthermore, in the coblation group, total hospitalization cost decreased by 27.73%, surgical cost increased by 94.98%, surgical material cost decreased by 10.33%, LOS shortened by 56.24%, and antimicrobial drug cost increased by 43.03%. In contrast, the non-coblation group showed a 23.94% increase in total hospitalization cost, a 57.08% increase in surgical procedure cost, a 33.88% increase in material cost, and a 30.14% reduction in LOS and a 26.0% decrease in antimicrobial drugs cost. In conclusion,from 2013 to 2022, total hospitalization cost for pediatric adenoidectomy in Beijing tertiary hospitals remained stable. Compared to non-coblation techniques, coblation was associated with a shorter LOS, lower total costs, a higher proportion of surgical fees, and a decreased proportion of material costs, without a significant increase in overall healthcare costs.