Cost drivers and cost composition in adult patients undergoing day-case inguinal hernia repair: a quantile regression analysis.

BACKGROUND

Day-case inguinal hernia repair is increasingly used, but cost structure and distributional cost drivers remain insufficiently characterized. We examined temporal trends, cost composition, and determinants of total costs.

METHODS

We retrospectively studied consecutive adults undergoing open or laparoscopic day-case inguinal hernia repair at Beijing Chao-Yang Hospital, 2018-2024. The primary outcome was total cost per episode (RMB). Annual cost components were described, and multivariable quantile regression estimated associations across q10-q90.

RESULTS

Among 12,550 repairs, mean cost fell in 2020, peaked in 2022, and stabilized thereafter. Materials were the largest cost component annually (57.02%-66.29%). Higher costs were associated with other-province origin, bilateral hernia, laparoscopic repair, additional diagnoses, and later calendar year. Lower costs were associated with older age, more prior hospitalizations, uninsured status, and selected sociodemographic factors. Several associations were stronger at higher quantiles.

CONCLUSIONS

Costs were materials-dominated and heterogeneous, supporting procurement-focused stewardship and refined payment calibration in ambulatory hernia care.