Composition and influencing factors of hospitalization costs in adult patients undergoing incisional hernia repair surgery.

Incisional hernias, a common complication following abdominal surgeries, can result in significant healthcare costs due to the need for surgical repair. Understanding the factors influencing hospitalization costs is essential for optimizing healthcare resource utilization and improving cost-effectiveness. This study aimed to analyze the composition and factors affecting hospitalization costs in adult patients undergoing incisional hernia repair surgery. We conducted a retrospective study of 2,777 adult patients who underwent abdominal wall incisional hernia repair at Beijing Chaoyang Hospital between January 2015 and July 2024. Data collected included demographic information, surgery-related factors, and hospitalization costs. The primary outcome was the total individual hospitalization cost, which was broken down into diagnostic, treatment, nursing, medication, biological, material, and miscellaneous costs. All costs were inflation-adjusted to 2024 constant CNY using China’s healthcare Consumer Price Index, with nominal-cost analyses performed as sensitivity analyses. Univariate and multivariate regression analyses were used to identify factors influencing hospitalization costs. The average total hospitalization cost was higher for females (CNY 49,419.14 ± 19,223.89) than for males (CNY 47,349.00 ± 20,427.63). Occupation also significantly influenced costs, with employees incurring higher costs (CNY 53,018.97 ± 21,330.08) compared to others (CNY 47,672.53 ± 19,230.43). Hospital stays of 17–71 days were associated with the highest costs (CNY 52,205.29 ± 19,724.75). Laparoscopic surgery was associated with significantly higher costs (CNY 58,675.76 ± 18,320.58) compared to open surgery (CNY 45,351.94 ± 19,004.04). No-mesh procedures were associated with lower costs (CNY 34,422.76 ± 21,321.03) compared with mesh repairs (CNY 48,960.91 ± 19,552.03). Over the study period, the average total hospitalization costs peaked in 2021 (CNY 56,560.61) and declined to their lowest in 2024 (CNY 40,921.26). Among all cost components, materials consistently accounted for the largest share (64.56–71.42%), followed by diagnosis (8.74%–14.64%), treatment (5.43%–13.14%), miscellaneous costs (2.64%–10.18%), medication (1.69%–8.58%), nursing (0.62–1.89%), and biological products (0%–0.85%). Multivariate analysis revealed that females (β = 0.058, P = 0.001), employees (β = 0.134, P < 0.001), hospital stays of 10–12 days (β = 0.330, P < 0.001), hospital stays of 13–16 days (β = 0.394, P < 0.001), hospital stays of 17–71 days (β = 0.485, P < 0.001), laparoscopic surgery (β = 0.462, P < 0.001), and absence of mesh use (β=–0.515, P < 0.001) were independent factors significantly influencing hospitalization costs. Component-level analyses showed that between-group cost differences were mainly driven by materials spending, particularly for laparoscopic surgery and mesh repair. Several demographic and clinical factors, including gender, occupation, length of stay, surgery type, and mesh use, significantly influence hospitalization costs in incisional hernia repair surgery. Identifying these factors allows healthcare providers and policymakers to develop strategies aimed at optimizing resource allocation and reducing unnecessary expenditures. These findings highlight the importance of cost-effective management strategies without compromising patient care, especially in high-cost surgical procedures such as laparoscopic hernia repair.