Cost-conscious decisions in the timing of operation for minimally symptomatic inguinal hernias in male patients

Aliasgher Khaku, Christopher S. Hollenbeak, David Soybel

Research output: Contribution to journalArticlepeer-review

Abstract

Background Expectant management (EM) and early open repair (OR) are safe and effective as initial management strategies for minimally symptomatic inguinal hernia in male patients. Extended follow-up of patients in EM protocols have shown that most patients will eventually require repair, but it is not clear which strategy is less costly over the long term. Methods We constructed a mathematical model to compare 3rd-party payer expenditures for EM vs OR or laparoscopic repair in a simulated cohort of patients with inguinal hernia. Cohort characteristics and expenditures were calibrated to recent randomized trials that reported initial follow-up and expenditures at 2 years and long-term crossover rates from EM to OR. Results Cost comparisons between OR and EM are sensitive to direct long-term costs of inpatient and outpatient care, the likelihood of crossover from EM to operation, cost differences between OR and laparoscopic repair, and the net present value of longer-term costs. Conclusions Our findings suggest that short-term costs of EM are less than those of OR and Lap-R, but early OR provides the highest long-term savings.

Original languageEnglish (US)
Pages (from-to)975-981
Number of pages7
JournalAmerican Journal of Surgery
Volume211
Issue number6
DOIs
StatePublished - Jun 1 2016

All Science Journal Classification (ASJC) codes

  • Surgery

Fingerprint Dive into the research topics of 'Cost-conscious decisions in the timing of operation for minimally symptomatic inguinal hernias in male patients'. Together they form a unique fingerprint.

Cite this