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Epidemiology and cost of ventral hernia repair: making the case for hernia research

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Abstract

Purpose

Ventral hernia repair (VHR) lacks standardization of care and exhibits variation in delivery. Complications of VHR, notably recurrence and infection, increase costs. Efforts at obtaining federal funding for VHR research are frequently unsuccessful, in part due to misperceptions that VHR is not a clinical challenge and has minimal impact on healthcare resources. We analyzed national trends for VHR performance and associated costs to demonstrate potential savings resulting from an improvement in outcomes.

Methods

Inpatient non-federal discharges for VHR were identified from the 2001–2006 Healthcare Cost and Utilization Project, supplemented by the Center for Disease Control 2006 National Survey of Ambulatory Surgery for outpatient estimates. The total number of VHRs performed in the US was estimated along with associated costs. Costs were standardized to 2010 US dollars using the Consumer Price Index and reported as mean with 95% confidence intervals (95% CI).

Results

The number of inpatient VHRs increased from 126,548 in 2001 to 154,278 in 2006. Including 193,543 outpatient operations, an estimated 348,000 VHRs were performed for 2006. Inpatient costs consistently rose with 2006 costs estimated at US $15,899 (95% CI $15,394–$16,404) per operation. Estimated cost for outpatient VHR was US $3,873 (95% CI $2,788–$4,958). The total cost of VHR for 2006 was US $3.2 billion.

Conclusions

VHRs continue to rise in incidence and cost. By reducing recurrence rate alone, a cost saving of US $32 million dollars for each 1% reduction in operations would result. Further research is necessary for improved understanding of ventral hernia etiology and treatment and is critical to cost effective healthcare.

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References

  1. Wechter ME, Pearlman MD, Hartmann KE, Wechter ME, Pearlman MD, Hartmann KE (2005) Reclosure of the disrupted laparotomy wound: a systematic review. Obstet Gynecol 106(2):376–383

    Article  PubMed  Google Scholar 

  2. Pans A, Elen P, Dewe W, Desaive C (1998) Long-term results of polyglactin mesh for the prevention of incisional hernias in obese patients. World J Surg 22(5):479–482, discussion 82–83

    Article  PubMed  CAS  Google Scholar 

  3. Trimbos JB, Smit IB, Holm JP, Hermans J (1992) A randomized clinical trial comparing two methods of fascia closure following midline laparotomy. Arch Surg 127(10):1232–1234

    Article  PubMed  CAS  Google Scholar 

  4. Luijendijk RW, Hop WC, van den Tol MP et al (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343(6):392–398

    Article  PubMed  CAS  Google Scholar 

  5. HCUP Nationwide Inpatient Sample (2006) Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/nisoverview.jsp

  6. National Survey of Ambulatory Surgery (2006) National Center for Health Statistics Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdcgov/nchs/nsas.htm

  7. Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev 3:CD007781

  8. Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237(1):129–135

    Article  PubMed  Google Scholar 

  9. Rutkow IM (1998) Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin N Am 78(6):941–951

    Article  PubMed  CAS  Google Scholar 

  10. Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin N Am 83(5):1045–1051

    Article  PubMed  Google Scholar 

  11. Earle D, Seymour N, Fellinger E, Perez A (2006) Laparoscopic versus open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc 20(1):71–75

    Article  PubMed  CAS  Google Scholar 

  12. den Hartog D, Dur AHM, Tuinebreijer WE, Kreis RW (2008) Open surgical procedures for incisional hernias. Cochrane Database of Syst Rev 3:CD006438

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Correspondence to B. K. Poulose.

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Poulose, B.K., Shelton, J., Phillips, S. et al. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16, 179–183 (2012). https://doi.org/10.1007/s10029-011-0879-9

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  • DOI: https://doi.org/10.1007/s10029-011-0879-9

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