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.