Effect of Surveillance on the Number of Hysterectomies in the Province of Saskatchewan

Abstract

In 1972 the College of Physicians and Surgeons of Saskatchewan appointed a committee to study hysterectomies because the Saskatchewan Department of Health had data showing that the annual number of hysterectomies carried out in the province had increased by 72.1 per cent between 1964 and 1971, whereas the number of women over 15 years of age had increased by 7.6 per cent. The committee compiled a list of indications for hysterectomy. Any hysterectomy carried out for one of these reasons was classified as justified, and the remainder as unjustified. Five hospitals were reviewed in 1970 and a further two in 1973. In 1974, all seven hospitals were reviewed again. In these hospitals, the average proportion of unjustified hysterectomies had dropped from 23.7 per cent at the time of the first review to 7.8 per cent in 1974. The total number of hysterectomies in the province dropped by 32.8 per cent between 1970 and 1974.

Revisiting the Most Informed Consumer of Surgical Services: The Physician-Patient

“…Dick et al (6) similarly explain the dramatic increase of hysterectomies in the Canadian province of Saskatchewan between 1964 and 1971 as a consequence of the introduction of compulsory health insurance in Canada.…”

Barriers to Care

“…In 1972, the College of Physicians and Surgeons of Saskatchewan appointed a study committee in response to the finding that the annual number of hysterectomies in the province had increased at a rate ten times greater than the increase in the number of adult women in the population during the study period. As the result of stipulating approved indications for hysterectomy, the number performed in the province dropped by one-third during a four year period (17). In similar fashion, Winnberg et al (\8) found that the feedback of information to the Vermont State Medical Society on disproportions in the number of tonsillectomies was associated with a significant red uction in state-wide rates.…”

Overtreatment in Surgery: Discussion Paper

“…In a similar study in Saskatchewan, a group of gynaecologists decided under which clinical circumstances a hysterectomy was 'justified' or 'not justified' (Dyck et al 1977). Feedback of 'justified' and 'not justified' operating rates resulted in a 32.8% decrease in the number of hysterectomies performed in the province between 1970 and 1974.…”