State-of-the-art of abdominal wall surgery in Italy: coding, reimbursement, hospitalisations and expenditure for surgical meshes

In this chapter, we present the state-of-the-art of abdominal wall surgery in Italy. In 2016, 83,427 hospitalisations for hernia repair were performed by public and private hospitals, the vast majority (87%) without complications. The expenditure for surgical meshes by public hospitals was equal to 21,281 million euro, with a 2.0% increase with respect to 2015. Currently, in Italy patients are classified based on their age, hernia location (inguinal/femoral/other) and presence/absence of complications. Clinical severity (e.g. hernia size), type of hernia (i.e. monolateral, bilateral and recurrent), type of intervention (open surgery vs. laparoscopy) and type of device are not considered. The level of reimbursement for hospitalisations varies across Italian regions. Special payments to encourage the use of innovative devices for hernia repair have not been introduced by any region.