探讨切口疝手术患者住院费用的影响因素，为制定合理的医疗费用控制策略提供依据。

根据纳入和排除标准，从首都医科大学附属北京朝阳医院的电子病历系统数据库中选取了2007—2022年疝和腹壁外科收治的切口疝手术患者为研究对象。收集患者的基本信息、疝相关信息、手术相关信息、费用相关信息等资料。采用分位数回归模型和分位数回归曲线图分析影响住院费用的因素，考察不同分位数下的影响因素。

本研究共纳入切口疝手术患者868名。女性患者63.36%（550/868）较男性多。单因素分析的结果显示，年龄、婚姻状况、职业、住院次数、付费方式、入院途径、住院年份、住院天数、主要诊断、其他诊断个数、手术方式、麻醉方式、手术愈合等级、重症监护、呼吸机使用和离院方式不同，住院费用差异有统计学意义（P<0.05）。分位数回归模型分析的结果显示，年龄较大的患者在q30费用组的住院费用明显升高，年龄每增加1岁，医疗费用平均增加161.76元（P=0.030）。少数民族住院费用在低分位费用组（q20、q30）和中分位费用组（q40），明显高于汉族，差异有统计学意义（P<0.05）。随住院次数增多住院费用在各分位数上呈显著降低趋势（P<0.05）。在付费方式中，选择"其他"方式付费的患者在q50~q70分位数下住院费用高于使用医保的患者（P<0.05）。通过急诊入院的患者在q40分位数的费用显著增加（P=0.004）。随住院年份增加，在q20~q90各分位数住院费用显著上升（P<0.05）。在q30~q90各分位数住院费用随住院天数的增加呈显著增加趋势（P<0.05）。相比于切口疝患者，切口疝伴有梗阻的患者在q40分位数组的费用增加了8796.24元，差异具有统计学意义（P=0.001）。药物过敏患者在q80分位数的费用显著降低（P<0.001）。腹腔镜手术方式的住院费用明显高于开放手术的住院费用，且在q10~q70各分位数呈显著上升趋势（P<0.05）。非医嘱离院的患者在q30~q40分位数费用较医嘱离院患者显著增加（P<0.05）。

住院费用高更常见于年龄较大的患者、少数民族、急诊、住院次数越少、住院年份越晚、住院天数越长、切口疝伴有肠梗阻、无药物过敏、非医嘱离院、"其他"付费方式以及接受腹腔镜手术的患者。未来研究需进一步拓展到其他疾病和手术类型，以期为医疗费用控制提供更全面的参考依据。

To investigate the factors influencing the hospitalization costs of patients undergoing incisional hernia surgery, to provide a basis for formulating reasonable medical cost control strategies.

Based on the inclusion and exclusion criteria, data were selected from the electronic medical record system database of Beijing Chao Yang Hospital, Capital Medical University, covering patients with incisional hernia surgeries from the Department of Hernia and Abdominal Wall Surgery between 2007and 2022. Information on patient demographics, hernia details, surgical data, and cost-related details were collected. Quantile regression models and quantile regression curve graphs were employed to analyze factors affecting hospitalization costs, assessing influences across different quantiles.

A total of 868 patients undergoing incisional hernia surgery were included in this study, with females accounting for 63.36% (550/868), outnumbering males. Univariate analysis indicated that factors such as age, marital status, occupation, number of hospitalizations, payment method, admission route, year of hospitalization, length of stay, primary diagnosis, number of additional diagnoses, surgical method, anesthesia method, surgical healing grade, intensive care, ventilator use, and method of discharge significantly influenced hospitalization costs (P<0.05). Quantile regression models revealed that older patients showed a significant increase in hospitalization costs in the q30 cost group, with an average increase of ¥161.76 for each year of age (P=0.030). Minority patients had notably higher costs in lower (q20, q30) and middle (q40) quantile groups compared to Han ethnicity (P<0.05). As the number of hospitalizations increased, costs significantly decreased across all quantiles (P<0.05). Patients who chose the "other" payment methods had higher costs in the q50-q70 quantiles compared to those using health insurance (P<0.05). Emergency admissions resulted in a significant cost increase in the q40 quantile (P=0.004). With the progression of hospitalization year, costs rose significantly across q20-q90 quantiles (P<0.05). A significant upward trend in costs across q30-q90 quantiles correlated with increased length of hospital stay (P<0.05). Compared to general incisional hernia patients, those with concurrent bowel obstruction experienced a cost increase of ¥8796.24 in the q40 quantile (P=0.001). Patients with drug allergies had significantly reduced costs in the q80 quantile (P<0.001). Laparoscopic surgery costs were significantly higher than open surgery and demonstrated an upward trend across q10-q70 quantiles (P<0.05). Non-medically advised discharges led to notable cost increases in the q30-q40 quantiles compared to medically advised discharges (P<0.05).

Higher hospitalization costs were more commonly observed in older patients, ethnic minorities, emergency admissions, fewer hospital stays, later hospitalization years, longer lengths of stay, patients with incisional hernia accompanied by bowel obstruction, those without drug allergies, non-medically advised discharges, "other" payment methods, and patients undergoing laparoscopic surgery. Future research should be extended to other diseases and surgical types to offer a comprehensive reference for medical cost control.