Trends in adenoidectomy in children in Beijing, China, 2013-2022

Objective Adenoidectomy is one of the most commonly performed surgical procedures in children. However, there is limited research on changes in costs and treatment methods. This study aims to evaluate the temporal trends in hospitalization costs for adenoidectomy among children in Beijing over a 10-year period.Methods We conducted a retrospective study using the data from regional health information platform of Beijing from 2013 to 2022. The study population comprised children under 14 years of age who underwent adenoidectomy. Data on hospitalization costs, length of stay, surgical approaches, and postoperative blood loss were collected. The Mann-Kendall trend test was applied to assess the statistical significance of trends.Results Over the past decade, a total of 26,911 children underwent adenoidectomy. The percentage of patients under 6 years of age increased significantly from 59.83% to 76.11% (Z = 2.15, P = 0.031). Only one case of postoperative bleeding required surgical hemostasis. All subsequent analyses focused exclusively on tertiary hospitals. The median cost of an adenoidectomy was 12425.82（IQR 11307.43,14955.42)，with a non-increasing trend (Z =-0.54,P=0.592). Overall, surgical costs showed an upward trend over the decade (Z=3.22, P=0.001), while the cost of surgical materials showed no significant increase (Z=1.79, P=0.074). Concurrently, the average length of hospital stay decreased remarkably from 10.56 days in 2013 to 3.26 days in 2022 (Z = -3.94, P < 0.001). The cost of perioperative antibiotics decreased (Z=-3.94, P < 0.001), while the cost of coagulation factors and blood transfusion remained stable (Z=-0.54, P=0.59; Z=0, P=1). Additionally, there was an escalation in the proportion of patients using coblation. Comparison of the two five-year periods from 2013 to 2017 and from 2018 to 2022 shows that in the latter period, for the group treated with coblation, the hospitalization costs decreased, the surgical costs increased, the costs of surgical materials decreased, the length of hospital stay shortened, and the costs of antibiotics and coagulation factors increased.Conclusions The overall hospitalization cost for pediatric adenoidectomy surgery did not increase significantly over the past decade, despite variations in specific cost components. The shift towards performing adenoidectomies at younger ages reflects evolving medical strategies, possibly aimed at improving long-term patient outcomes. Additionally, the reduction in hospital stay durations suggests enhanced efficiency in postoperative care protocols. The adoption of coblation has not resulted in a significant increase in overall costs. These findings highlight the complex interplay between clinical advancements, cost management strategies, and patient care in pediatric otolaryngology. They provide important evidence for optimizing tiered medical systems and promoting the use of outpatient surgery. Future research should further explore how to promote the popularization of adenoidectomy in primary healthcare institutions through policy guidance and technological innovation, while reducing medical costs and improving patient satisfaction.