To investigate the factors influencing hospitalization costs of adult patients undergoing day surgery for inguinal hernia, and to provide a basis for developing rational medical cost control strategies.

Based on inclusion and exclusion criteria, adult patients who underwent day surgery for inguinal hernia between January 2018 and June 2023 in the Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital, Capital Medical University, were selected from the electronic medical record system database. Patients' basic information, hernia-related information, surgery-related information, and cost-related information were collected. Quantile regression models and quantile regression curves were used to analyze the factors affecting hospitalization costs and to examine the factors at different quantiles.

A total of 7,985 patients undergoing day surgery for inguinal hernia were included in this study. Male patients constituted 91.1% (7272/7985) of the sample, outnumbering female patients. Univariate analysis showed that age, number of hospitalizations, admission year, number of other diagnoses, surgical method, and the use of antimicrobial drugs were significantly related with different hospitalization costs (P<0.05). Quantile regression model analysis revealed that in terms of age, there was a negative correlation between patient age and hospitalization costs across various quantiles. For older patients in the q70 cost group, hospitalization costs significantly decreased, with an average reduction of 100.681 Yuan per additional year of age (P<0.001). Regarding the number of hospital stays (patients with hospitalizations > 1 were hospitalized for other diseases in the past), compared to patients with ≥3 hospitalizations, patients hospitalized twice showed a significant increase in costs at the q10 to q20, q50, and q80 to q90 quantiles (P<0.05), and patients hospitalized once exhibited a significant increase in costs across all quantiles (P<0.001). As admission years increased, there was a significant upward trend in hospitalization costs at all quantiles (P<0.05). In terms of the number of other diagnoses, compared to patients with ≥3 other diagnoses, patients with no other diagnoses showed a slight decrease in costs at the q20 quantile (P<0.001), while costs significantly increased at the q60 and q90 quantiles (P<0.05); for patients with one other diagnosis, costs significantly increased at the q40-q60, and q90 quantiles (P<0.05); and for patients with two other diagnoses, costs significantly increased from the q40 to q90 quantiles (P<0.05). Regarding surgical methods, costs for laparoscopic surgery were significantly higher than that for open surgery across the q10 to q90 quantiles, with an upward trend (P<0.001). Finally, compared to patients who did not use antimicrobial drugs, those who did showed a significant increase in hospitalization costs (P<0.001).

Higher hospitalization costs were more common among patients who were younger, had fewer previous hospitalizations, were admitted in later years, had more other diagnoses, underwent laparoscopic surgery, and used antimicrobial drugs. Future research should further expand to other diseases and types of surgery to provide a more comprehensive reference for medical cost control.