Trends and determinants of hospitalization costs for umbilical hernia: a 13-year retrospective analysis from 2012 to...

Umbilical hernia is a common surgical condition that imposes significant economic burdens on healthcare systems. Despite its prevalence, factors influencing hospitalization costs associated with umbilical hernia repairs remain inadequately understood, particularly in China. This study aimed to analyze trends in hospitalization costs and identify key determinants influencing these costs over a 13-year period.

We retrospectively analyzed data from 1,578 adult patients who underwent umbilical hernia repair surgery at Beijing Chaoyang Hospital from January 2012 to December 2024, including 146 emergent/urgent cases and 1,432 elective cases. Patient demographic information, clinical characteristics, surgical methods, and cost components were collected from the hospital's electronic medical record system. Univariate and multivariate linear regression analyses were conducted to identify independent predictors of total hospitalization costs, which were log-transformed to approximate normality.

A total of 1,578 patients were analyzed, with a mean hospitalization cost of 32,218.17 ± 18,624.60 CNY. Hospitalization costs showed an upward trend from 21,756.86 CNY in 2012, peaking at 41,314.14 CNY in 2021, followed by a decrease to 25,692.89 CNY in 2024. Material costs consistently constituted the largest proportion of total hospitalization expenses. Multivariable linear regression analysis identified several independent factors associated with higher total hospitalization costs, including later admission years (2016-2019: +30.4%, P < 0.001; 2020-2024: +45.4%, P < 0.001), laparoscopic repair (+107.9%, P < 0.001), mesh use (+108.2%, P < 0.001), ICU admission (+68.6%, P < 0.001), general anesthesia (+36.7%, P < 0.001) and combined anesthesia (+31.8%, P < 0.001), prolonged length of stay (6-7 days: +55.1%; 8-9 days: +63.6%; 10-42 days: +87.0%; all P < 0.001), gangrenous umbilical hernia (+118.0%, P = 0.013), and a higher number of additional diagnoses (1: +10.8%, P = 0.034; 2: +20.7%, P < 0.001; ≥3: +35.3%, P < 0.001).

Hospitalization costs for umbilical hernia repair were significantly influenced by admission years, surgical approach, mesh use, ICU admission, length of hospital stay, anesthesia method, diagnostic complexity, and comorbidities. These findings provide important insights for clinicians and healthcare policymakers, highlighting potential areas for cost optimization, resource allocation, and policy interventions to reduce the economic burdens associated with umbilical hernia surgery.