Piotr J Bachul, MD1, Marek Rudnicki, MD, PhD, FACS2. 1University of Chicago, 2University of Illinois, Advocate Masonic Medical Center
INTRODUCTION: Inguinal hernia repairs are considered as one of the most common procedures in modern practice. Laparoscopic repairs appear to have advantages over the open approach. Relatively little information is available regarding the utilization of healthcare services for these commonly performed procedures in the United States. The redesigned Healthcare Cost and Utilization Project (HCUP) Database offers comparisons between HCUP State Ambulatory Surgery and Services databases with statistics from the HCUP State Inpatient databases (nine states participated in the most recent data collection in 2013). This new databank allows more detailed insight into ambulatory trends in utilization of healthcare services.
MATERIAL AND METHODS: The HCUP National Inpatient Sample was queried for inguinal hernia repairs performed in 2013, using ICD-9 procedure codes 17.11 – 17.13, 17.21 – 17.24 for laparoscopic and 53.00 – 53.17 for open inguinal hernia repairs. Ambulatory vs. inpatient settings were compared for frequency, patients’ demographics and payer using chi-square statistical analysis.
RESULTS: A total of 160 935 inguinal hernia repairs were identified in the referred 2013 database. 131 354 (81.6%) were done in ambulatory setting vs. 29 581 (18.4%) as an inpatient treatment. Overall, majority of repairs were done in open manner (123 349 vs 37 586 laparoscopic, 76.6% vs. 23.4%). Patients in age range between 18-44 and 45-64 had highest chance of getting laparoscopic repair (30.7% and 30%, respectively) vs. those who were younger than 18 at maximum rate of 2.8%. Laparoscopic technique was employed in 26% of cases done in ambulatory setting whereas only in 11.5% cases were performed as inpatients. Laparoscopic repair was most commonly used in patients with private insurance (30.6% in ambulatory vs 15% in the hospital setting).
CONCLUSIONS: In the United States, inguinal hernia repairs are performed predominantly in ambulatory settings. Despite the expected increase in its utilization, laparoscopic technique is only used in one out of four patients, usually for adults between 18–64. Laparoscopic repairs are done in ambulatory settings more than twice as inpatients. Patients with private insurance tend to have laparoscopic surgery more often than patients covered by other payers. It needs to be mentioned that the collected data is reflective of a limited sample of hernia surgery practiced in the US.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88442
Program Number: P032
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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