Document Detail

Patient preferences, satisfaction, and resource use in office evacuation of early pregnancy failure.
MedLine Citation:
PMID:  16816063     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine patient treatment preferences and satisfaction with an office-based procedure for early pregnancy failure and to compare resource use and cost between office and operating room management of early pregnancy failure. METHODS: This study was a prospective observational study of 165 women presenting for surgical management of early pregnancy failure. Participants completed a preoperative questionnaire addressing treatment preferences and expectations and a postoperative questionnaire measuring level of pain experienced and satisfaction with care. Resource use was determined by measuring the time patients spent at the health care facility and the actual procedure time. Cost was estimated using an institutional database. RESULTS: One hundred fifteen women from the office and 50 from the operating room were enrolled. Patients selecting outpatient management scored "privacy," "avoiding going to sleep," and "previous experience" higher than the operating room group (P < .05). Patients who perceived that their physicians preferred one procedure over the other were more likely to select that procedure (P < .001). Satisfaction was high in both groups, and underestimating the procedure's discomfort was negatively associated with satisfaction (P < .002). Costs were greater than two-fold higher in the operating room group compared with the office group (P < .01). Complications were uncommon, but hemorrhage-related complications were four times more common in the operating room group than in the office group (P < .01). CONCLUSION: Office-based surgical management of early pregnancy failure is an acceptable option for many women and offers substantial resource and cost savings. LEVEL OF EVIDENCE: II-2.
Vanessa K Dalton; Lisa Harris; Carol S Weisman; Ken Guire; Laura Castleman; Dan Lebovic
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  108     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-03     Completed Date:  2006-08-10     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-10     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Womens' Hospital, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.
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MeSH Terms
Abortion, Incomplete / surgery
Ambulatory Surgical Procedures / economics*,  psychology
Cost Savings
Dilatation and Curettage* / economics
Embryo Loss / surgery
Fetal Death / surgery*
Health Care Costs
Health Resources / utilization
Hospitalization / economics
Logistic Models
Patient Satisfaction*
Postoperative Complications
Pregnancy Trimester, First
Grant Support
1 K12 HD01438-01/HD/NICHD NIH HHS

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