Document Detail


Abdominal hysterectomy practice patterns in the United States.
MedLine Citation:
PMID:  9989898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe nationwide practice trends for two principal techniques of abdominal hysterectomy in the United States, numbers and rates of total (TAH) and supracervical (SCH) hysterectomy were reviewed with charges for each operation. METHODS: Practice patterns for all inpatient TAH and SCH discharges in the US from 1991 to 1994 were studied using HCUP-3 NIS, a nationwide hospital discharge database. Hysterectomies performed for malignant disease, vaginally or with laparoscopic assistance were not sampled. For each year studied, the number and rate of TAH and SCH, average length of stay (LOS), and mean institutional charge were evaluated. RESULTS: From 1991 to 1994, the US TAH rate (cases/10000 females) decreased significantly from 25.7 to 20.5 (P = 0.02). During the same interval the SCH rate increased significantly from 0.16 to 0.41 (P = 0.04). Nevertheless, TAH accounted for > 99% of all abdominal hysterectomies for each of the 4 years evaluated. The mean institutional charges for the two operations generally depicted SCH to be more costly than TAH. CONCLUSION: The national rates of TAH and SCH rates changed significantly in the United States from 1991 to 1994, with TAH declining and SCH increasing. This mix of cases continues to reflect a strong preference for TAH. Although hospital charges for both procedures increased during this study, these data show that SCH is more expensive than TAH. The much lower utilization of SCH renders nominal its impact on national healthcare expenditures, however. Further studies are needed to assess specific causative factors for these changes in US hysterectomy technique.
Authors:
E S Sills; J Saini; C A Steiner; M McGee; H F Gretz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  63     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-04-22     Completed Date:  1999-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  277-83     Citation Subset:  IM    
Affiliation:
Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, New York Hospital-Cornell Medical Center, New York, USA. dr.sills@reproductivehealthctr.com
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MeSH Terms
Descriptor/Qualifier:
Female
Hospital Charges / statistics & numerical data,  trends
Humans
Hysterectomy / methods,  statistics & numerical data,  utilization*
Laparoscopy / statistics & numerical data,  utilization
Length of Stay / economics,  statistics & numerical data
Physician's Practice Patterns / statistics & numerical data*,  trends
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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