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Long-Term Trends and Predictors of Medical Resource Utilization and Medical Outcomes in Inguinal Hernia Repair: A Nationwide Cohort Study

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Abstract

Background

Few studies have comprehensively and systematically analyzed nationwide samples. This study purposed to explore temporal trends and predictors of medical resource utilization and medical outcomes in these patients to obtain data that can be used to improve healthcare policies and to support clinical and administrative decision-making.

Methods

This study used nationwide population data contained in the Longitudinal Health Insurance Database of Taiwan. The 14,970 inguinal hernia repair patients were enrolled in this study (age range, 18–100 years) from 1997 to 2013 in Taiwan. After temporal trends analysis of demographic characteristics, clinical characteristics, and institutional characteristics, predictors of postoperative medical resource utilization and medical outcomes were evaluated through multiple linear regression analysis and Cox regression analysis.

Results

The prevalence of inguinal hernia repair per 100,000 population significantly decreased from 195.38 in 1997 to 39.66 in 2013 (p < 0.05). Demographic characteristics, clinical characteristics, and institutional characteristics were significantly associated with postoperative medical resource utilization and medical outcomes (p < 0.05). Of these characteristics, both surgeon volume and hospital volume had the strongest association.

Conclusions

The inguinal hernia repair prevalence rate gradually decreased during the study period. Demographic characteristics, clinical characteristics, and institutional characteristics had strong associations with postoperative medical resource utilization and medical outcomes. Furthermore, hospital volume and surgeon volume had the strongest associations with postoperative medical resource utilization and medical outcomes. Additionally, providing the education needed to make the most advantageous medical decisions would be a great service not only to patients and their families, but also to the general population.

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Acknowledgements

This study was supported by funding from the NSYSU-KMU JOINT RESEARCH PROJECT (NSYSUKMU 109-P001) in Taiwan.

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Authors and Affiliations

  1. Department of Nursing, Meiho University, Pingtung, Taiwan

    Yi-Hung Kuo

  2. Department of General Surgery and Medical Research Department, E-Da Cancer Hospital, Kaohsiung, Taiwan

    Chong-Chi Chiu

  3. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan

    Chong-Chi Chiu

  4. Department of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Li-Ya Tseng

  5. Department of Emergency Medicine, Yunlin Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Yunlin, Taiwan

    Chien-Hung Wu

  6. Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Min Hui Chen

  7. Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Yu-Chao Fang & Chun-Hsiang Chen

  8. Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Wei-Chi Tseng

  9. Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan

    Shu-Chuan Jennifer Yeh & Hon-Yi Shi

  10. Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Shu-Chuan Jennifer Yeh & Hon-Yi Shi

  11. Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Hon-Yi Shi

  12. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan

    Hon-Yi Shi

Authors
  1. Yi-Hung Kuo
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  2. Chong-Chi Chiu
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  3. Li-Ya Tseng
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  4. Chien-Hung Wu
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  5. Min Hui Chen
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  6. Yu-Chao Fang
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  7. Wei-Chi Tseng
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  8. Chun-Hsiang Chen
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  9. Shu-Chuan Jennifer Yeh
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  10. Hon-Yi Shi
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Corresponding author

Correspondence to Hon-Yi Shi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUH-IRB-2019067).

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Cite this article

Kuo, YH., Chiu, CC., Tseng, LY. et al. Long-Term Trends and Predictors of Medical Resource Utilization and Medical Outcomes in Inguinal Hernia Repair: A Nationwide Cohort Study. World J Surg 45, 1771–1778 (2021). https://doi.org/10.1007/s00268-021-06012-8

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  • DOI: https://doi.org/10.1007/s00268-021-06012-8

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