Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States
Background The health-care burden related to ventral hernia management is substantial, with more than 3 billion dollars in expenditures annually in the US. Previous studies have suggested that the utilization of laparoscopic repair remains relatively low although national volume estimates have not b...
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| creator | Funk, Luke M. Perry, Kyle A. Narula, Vimal K. Mikami, Dean J. Melvin, W. Scott |
| description | Background
The health-care burden related to ventral hernia management is substantial, with more than 3 billion dollars in expenditures annually in the US. Previous studies have suggested that the utilization of laparoscopic repair remains relatively low although national volume estimates have not been reported. We sought to estimate the inpatient national volume of elective ventral hernia surgery and characterize the proportion of laparoscopic versus open operations.
Methods
We analyzed data from the Nationwide Inpatient Sample to identify adults with a diagnosis of an umbilical, incisional, or ventral hernia who underwent an elective inpatient repair between 2009 and 2010. Cases that involved other major abdominal or pelvic operations were excluded. Covariates included patient demographics, surgical approach, and use of mesh. National surgical volume estimates were generated and length of stay and total hospital charges were compared for laparoscopic versus open repairs.
Results
A total of 112,070 ventral hernia repairs were included in the analysis: 72.1 % (
n
= 80,793) were incisional hernia repairs, while umbilical hernia repairs comprised only 6.9 % (
n
= 7,788). Laparoscopy was utilized in 26.6 % (
n
= 29,870) of cases. Mesh was placed in 85.8 % (
n
= 96,265) of cases, including 49.3 % (
n
= 3,841) of umbilical hernia repairs and 90.1 % (
n
= 72,973) of incisional hernia repairs. Length of stay and total hospital charges were significantly lower for laparoscopic umbilical, incisional, and “other” ventral hernia repairs (
p
values all |
| doi_str_mv | 10.1007/s00464-013-3075-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1443402311</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3092242231</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-d0bbe8b83157b1b7dbb9a23a34945aabf298d447f36b25a583652642f949031f3</originalsourceid><addsrcrecordid>eNp1kUtr3DAURkVpaCaPH9BNEXTTjZOrhx9aliFpAoEumqzFlS3PKNjyRJIb8u8jZ6alBLq6Ejrnu4iPkM8MLhhAfRkBZCULYKIQUJeF_EBWTApecM6aj2QFSkDBayWPyUmMj5BxxcpP5JiLpoIKmhV5Ws8hWJ-ox-QmjwPdBWyTay3dYUo2-Ej7KVDn89Ut4IgeN3ZcjlNPf-cZsoWmm0a3-M84DHSbRYfZomlr6YN3yXb0V8Jk4xk56nGI9vwwT8nD9dX9-qa4-_njdv39rmhFzVPRgTG2MY1gZW2YqTtjFHKBQipZIpqeq6aTsu5FZXiJZSOqkleS90oqEKwXp-TbPncXpqfZxqRHF1s7DOjtNEfNpBQSuGAso1_foY_THPJn3igABqoWmWJ7qg1TjMH2ehfciOFFM9BLH3rfh8596KUPLbPz5ZA8m9F2f40_BWSA74GYn_zGhn9W_zf1FeablbU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1440010973</pqid></control><display><type>article</type><title>Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Funk, Luke M. ; Perry, Kyle A. ; Narula, Vimal K. ; Mikami, Dean J. ; Melvin, W. Scott</creator><creatorcontrib>Funk, Luke M. ; Perry, Kyle A. ; Narula, Vimal K. ; Mikami, Dean J. ; Melvin, W. Scott</creatorcontrib><description>Background
The health-care burden related to ventral hernia management is substantial, with more than 3 billion dollars in expenditures annually in the US. Previous studies have suggested that the utilization of laparoscopic repair remains relatively low although national volume estimates have not been reported. We sought to estimate the inpatient national volume of elective ventral hernia surgery and characterize the proportion of laparoscopic versus open operations.
Methods
We analyzed data from the Nationwide Inpatient Sample to identify adults with a diagnosis of an umbilical, incisional, or ventral hernia who underwent an elective inpatient repair between 2009 and 2010. Cases that involved other major abdominal or pelvic operations were excluded. Covariates included patient demographics, surgical approach, and use of mesh. National surgical volume estimates were generated and length of stay and total hospital charges were compared for laparoscopic versus open repairs.
Results
A total of 112,070 ventral hernia repairs were included in the analysis: 72.1 % (
n
= 80,793) were incisional hernia repairs, while umbilical hernia repairs comprised only 6.9 % (
n
= 7,788). Laparoscopy was utilized in 26.6 % (
n
= 29,870) of cases. Mesh was placed in 85.8 % (
n
= 96,265) of cases, including 49.3 % (
n
= 3,841) of umbilical hernia repairs and 90.1 % (
n
= 72,973) of incisional hernia repairs. Length of stay and total hospital charges were significantly lower for laparoscopic umbilical, incisional, and “other” ventral hernia repairs (
p
values all <0.001). Total hospital charges during this 2-year period approached 4 billion dollars ($746 million for laparoscopic repair; $3 billion for open repair).
Conclusions
Utilization of laparoscopy for elective abdominal wall hernia repair remains relatively low in the US despite its excellent outcomes. Given the substantial financial burden associated with these hernias, future research focused on preventing the development and optimizing the surgical treatment of ventral abdominal wall hernias is warranted.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-013-3075-4</identifier><identifier>PMID: 23860608</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Abdomen ; Abdominal Surgery ; Abdominal Wall - surgery ; Age Distribution ; Comorbidity ; Cost of Illness ; Elective Surgical Procedures - economics ; Elective Surgical Procedures - statistics & numerical data ; Estimates ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Hernia, Ventral - economics ; Hernia, Ventral - surgery ; Hernias ; Herniorrhaphy - economics ; Herniorrhaphy - methods ; Hospital Charges ; Hospitalization ; Hospitals ; Humans ; Inpatients ; Laparoscopy ; Laparoscopy - economics ; Laparoscopy - utilization ; Length of stay ; Length of Stay - economics ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Patients ; Practice Patterns, Physicians' - statistics & numerical data ; Proctology ; Sex Distribution ; Surgery ; Surgical Mesh - economics ; United States</subject><ispartof>Surgical endoscopy, 2013-11, Vol.27 (11), p.4104-4112</ispartof><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-d0bbe8b83157b1b7dbb9a23a34945aabf298d447f36b25a583652642f949031f3</citedby><cites>FETCH-LOGICAL-c372t-d0bbe8b83157b1b7dbb9a23a34945aabf298d447f36b25a583652642f949031f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-013-3075-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-013-3075-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23860608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Funk, Luke M.</creatorcontrib><creatorcontrib>Perry, Kyle A.</creatorcontrib><creatorcontrib>Narula, Vimal K.</creatorcontrib><creatorcontrib>Mikami, Dean J.</creatorcontrib><creatorcontrib>Melvin, W. Scott</creatorcontrib><title>Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
The health-care burden related to ventral hernia management is substantial, with more than 3 billion dollars in expenditures annually in the US. Previous studies have suggested that the utilization of laparoscopic repair remains relatively low although national volume estimates have not been reported. We sought to estimate the inpatient national volume of elective ventral hernia surgery and characterize the proportion of laparoscopic versus open operations.
Methods
We analyzed data from the Nationwide Inpatient Sample to identify adults with a diagnosis of an umbilical, incisional, or ventral hernia who underwent an elective inpatient repair between 2009 and 2010. Cases that involved other major abdominal or pelvic operations were excluded. Covariates included patient demographics, surgical approach, and use of mesh. National surgical volume estimates were generated and length of stay and total hospital charges were compared for laparoscopic versus open repairs.
Results
A total of 112,070 ventral hernia repairs were included in the analysis: 72.1 % (
n
= 80,793) were incisional hernia repairs, while umbilical hernia repairs comprised only 6.9 % (
n
= 7,788). Laparoscopy was utilized in 26.6 % (
n
= 29,870) of cases. Mesh was placed in 85.8 % (
n
= 96,265) of cases, including 49.3 % (
n
= 3,841) of umbilical hernia repairs and 90.1 % (
n
= 72,973) of incisional hernia repairs. Length of stay and total hospital charges were significantly lower for laparoscopic umbilical, incisional, and “other” ventral hernia repairs (
p
values all <0.001). Total hospital charges during this 2-year period approached 4 billion dollars ($746 million for laparoscopic repair; $3 billion for open repair).
Conclusions
Utilization of laparoscopy for elective abdominal wall hernia repair remains relatively low in the US despite its excellent outcomes. Given the substantial financial burden associated with these hernias, future research focused on preventing the development and optimizing the surgical treatment of ventral abdominal wall hernias is warranted.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Abdominal Wall - surgery</subject><subject>Age Distribution</subject><subject>Comorbidity</subject><subject>Cost of Illness</subject><subject>Elective Surgical Procedures - economics</subject><subject>Elective Surgical Procedures - statistics & numerical data</subject><subject>Estimates</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hernia, Ventral - economics</subject><subject>Hernia, Ventral - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - economics</subject><subject>Herniorrhaphy - methods</subject><subject>Hospital Charges</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Laparoscopy</subject><subject>Laparoscopy - economics</subject><subject>Laparoscopy - utilization</subject><subject>Length of stay</subject><subject>Length of Stay - economics</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Patients</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Proctology</subject><subject>Sex Distribution</subject><subject>Surgery</subject><subject>Surgical Mesh - economics</subject><subject>United States</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUtr3DAURkVpaCaPH9BNEXTTjZOrhx9aliFpAoEumqzFlS3PKNjyRJIb8u8jZ6alBLq6Ejrnu4iPkM8MLhhAfRkBZCULYKIQUJeF_EBWTApecM6aj2QFSkDBayWPyUmMj5BxxcpP5JiLpoIKmhV5Ws8hWJ-ox-QmjwPdBWyTay3dYUo2-Ej7KVDn89Ut4IgeN3ZcjlNPf-cZsoWmm0a3-M84DHSbRYfZomlr6YN3yXb0V8Jk4xk56nGI9vwwT8nD9dX9-qa4-_njdv39rmhFzVPRgTG2MY1gZW2YqTtjFHKBQipZIpqeq6aTsu5FZXiJZSOqkleS90oqEKwXp-TbPncXpqfZxqRHF1s7DOjtNEfNpBQSuGAso1_foY_THPJn3igABqoWmWJ7qg1TjMH2ehfciOFFM9BLH3rfh8596KUPLbPz5ZA8m9F2f40_BWSA74GYn_zGhn9W_zf1FeablbU</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Funk, Luke M.</creator><creator>Perry, Kyle A.</creator><creator>Narula, Vimal K.</creator><creator>Mikami, Dean J.</creator><creator>Melvin, W. Scott</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States</title><author>Funk, Luke M. ; Perry, Kyle A. ; Narula, Vimal K. ; Mikami, Dean J. ; Melvin, W. Scott</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-d0bbe8b83157b1b7dbb9a23a34945aabf298d447f36b25a583652642f949031f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Abdominal Wall - surgery</topic><topic>Age Distribution</topic><topic>Comorbidity</topic><topic>Cost of Illness</topic><topic>Elective Surgical Procedures - economics</topic><topic>Elective Surgical Procedures - statistics & numerical data</topic><topic>Estimates</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernia, Ventral - economics</topic><topic>Hernia, Ventral - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - economics</topic><topic>Herniorrhaphy - methods</topic><topic>Hospital Charges</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Laparoscopy</topic><topic>Laparoscopy - economics</topic><topic>Laparoscopy - utilization</topic><topic>Length of stay</topic><topic>Length of Stay - economics</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Patients</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Proctology</topic><topic>Sex Distribution</topic><topic>Surgery</topic><topic>Surgical Mesh - economics</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Funk, Luke M.</creatorcontrib><creatorcontrib>Perry, Kyle A.</creatorcontrib><creatorcontrib>Narula, Vimal K.</creatorcontrib><creatorcontrib>Mikami, Dean J.</creatorcontrib><creatorcontrib>Melvin, W. Scott</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Funk, Luke M.</au><au>Perry, Kyle A.</au><au>Narula, Vimal K.</au><au>Mikami, Dean J.</au><au>Melvin, W. Scott</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>27</volume><issue>11</issue><spage>4104</spage><epage>4112</epage><pages>4104-4112</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
The health-care burden related to ventral hernia management is substantial, with more than 3 billion dollars in expenditures annually in the US. Previous studies have suggested that the utilization of laparoscopic repair remains relatively low although national volume estimates have not been reported. We sought to estimate the inpatient national volume of elective ventral hernia surgery and characterize the proportion of laparoscopic versus open operations.
Methods
We analyzed data from the Nationwide Inpatient Sample to identify adults with a diagnosis of an umbilical, incisional, or ventral hernia who underwent an elective inpatient repair between 2009 and 2010. Cases that involved other major abdominal or pelvic operations were excluded. Covariates included patient demographics, surgical approach, and use of mesh. National surgical volume estimates were generated and length of stay and total hospital charges were compared for laparoscopic versus open repairs.
Results
A total of 112,070 ventral hernia repairs were included in the analysis: 72.1 % (
n
= 80,793) were incisional hernia repairs, while umbilical hernia repairs comprised only 6.9 % (
n
= 7,788). Laparoscopy was utilized in 26.6 % (
n
= 29,870) of cases. Mesh was placed in 85.8 % (
n
= 96,265) of cases, including 49.3 % (
n
= 3,841) of umbilical hernia repairs and 90.1 % (
n
= 72,973) of incisional hernia repairs. Length of stay and total hospital charges were significantly lower for laparoscopic umbilical, incisional, and “other” ventral hernia repairs (
p
values all <0.001). Total hospital charges during this 2-year period approached 4 billion dollars ($746 million for laparoscopic repair; $3 billion for open repair).
Conclusions
Utilization of laparoscopy for elective abdominal wall hernia repair remains relatively low in the US despite its excellent outcomes. Given the substantial financial burden associated with these hernias, future research focused on preventing the development and optimizing the surgical treatment of ventral abdominal wall hernias is warranted.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23860608</pmid><doi>10.1007/s00464-013-3075-4</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdomen Abdominal Surgery Abdominal Wall - surgery Age Distribution Comorbidity Cost of Illness Elective Surgical Procedures - economics Elective Surgical Procedures - statistics & numerical data Estimates Female Gastroenterology Gynecology Hepatology Hernia, Ventral - economics Hernia, Ventral - surgery Hernias Herniorrhaphy - economics Herniorrhaphy - methods Hospital Charges Hospitalization Hospitals Humans Inpatients Laparoscopy Laparoscopy - economics Laparoscopy - utilization Length of stay Length of Stay - economics Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Patients Practice Patterns, Physicians' - statistics & numerical data Proctology Sex Distribution Surgery Surgical Mesh - economics United States |
| title | Current national practice patterns for inpatient management of ventral abdominal wall hernia in the United States |
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