Document Detail


Payer costs in patients undergoing uterine artery embolization, hysterectomy, or myomectomy for treatment of uterine fibroids.
MedLine Citation:
PMID:  17911509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare health resource use and medical costs in patients with uterine leiomyomas treated with hysterectomy, myomectomy, or uterine artery embolization (UAE). MATERIALS AND METHODS: Patients who underwent hysterectomy, myomectomy, or UAE for leiomyomas were identified from a nationally representative private payer claims database based on their diagnosis and procedure codes. The study included patients with no prior hysterectomy, myomectomy, or UAE and no previous diagnosis of gynecologic cancer. Health resource use and medical costs were evaluated over a period of 12 months. RESULTS: The study included 2,836 hysterectomy, 704 myomectomy, and 125 UAE patients. Average patient ages were 46 years for hysterectomy, 38 years for myomectomy, and 45 years for UAE (P < .001). Median UAE procedure costs were $5,968, compared with $7,299 for myomectomy (P = .031) and $7,707 for hysterectomy (P < .001). Median total 12-month payer costs were not significantly different among the three procedures ($10,519 for UAE vs $9,652 for myomectomy [P = .372] and $10,044 for hysterectomy [P = .813]). There were no differences in overall hospital admissions or emergency room visits after the procedures. Patients who underwent UAE had greater fibroid-related hospital and physician office use beyond 30 days after treatment (P < .001). During this period, 65.6% of patients treated with UAE had at least one imaging study, versus 37.1% of those treated with myomectomy (P < .001) and 14.1% of those treated with hysterectomy (P < .001). CONCLUSIONS: Procedure costs were significantly lower for UAE versus myomectomy and hysterectomy, but there was no difference in total 12-month payer costs. Postprocedural imaging appears to be a factor in total UAE costs. Further research is needed to better understand the role of imaging studies after UAE.
Authors:
Carole J Dembek; Elise M Pelletier; Keith B Isaacson; James B Spies
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  18     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-03     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1207-13     Citation Subset:  IM    
Affiliation:
Health Economics & Reimbursement, Boston Scientific Corporation, Natick, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arteries
Cost-Benefit Analysis
Diagnostic Imaging / economics
Emergency Service, Hospital / economics
Female
Gynecologic Surgical Procedures / economics*,  methods
Health Care Costs*
Health Care Surveys
Health Resources / economics*,  utilization
Hospitalization / economics
Humans
Hysterectomy / economics*
Insurance, Health, Reimbursement / economics*
Leiomyomatosis / economics*,  pathology,  surgery,  therapy
Middle Aged
Office Visits / economics
Retrospective Studies
Time Factors
Treatment Outcome
United States
Uterine Neoplasms / economics*,  pathology,  surgery,  therapy

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


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