Variation in hysterectomy rates across small geographic areas of Massachusetts

Haas, Susan; Acker, David; Donahue, Charles L.; Katz, Martha Ellen

doi:10.1016/0002-9378(93)90152-9

Cited by 34 publications

(10 citation statements)

References 17 publications

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“…14 Although imperfect, the reproducibility of the appropriateness method is markedly better. Three-to-fivefold variations in the rate of use of hysterectomy have been reported [15][16][17] and have been attributed to variability among physicians. 18 Although imperfect, the appropriateness method is less variable.…”

Section: Discussionmentioning

confidence: 99%

The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures

et al. 1998

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Section: Discussionmentioning

confidence: 99%

The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures

et al. 1998

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“…The diversity of symptoms can have an immense influence on women`s quality of life, affecting aspects of her daily routine, general health and sense of wellbeing. Consequently, hysterectomy rates vary widely between countries and over small geographic areas within the countries [21]. This substantial variation in hysterectomy rates mainly according to geographic, patient-related, and physician-related factors.…”

Section: Discussionmentioning

confidence: 99%

Indications for a Hysterectomy at Jordan University Hospital : A Teaching Hospital Experience

Saleh

Fram

Sumrein

2013

JMJ

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Background and Aims: The indications for hysterectomy have changed due to the introduction of many alternatives. However, it is still the most common major gynecological operation. Therefore, this study was conducted to study the indications for a hysterectomy in a teaching hospital. Materials and Methods: This is a retrospective study analyzing the indications for hysterectomy in a teaching hospital over a period of two years (2008-2009). In total, 148 hysterectomies were analyzed. The case notes of these patients were reviewed. Results: The mean age was 46.6 year. Bleeding disorders, uterine fibroids, and abdominal pain were the most frequent indications accounting for 68%. Only 15% were performed due to malignant or premalignant conditions. The final histopathology reports revealed that the most common finding in the uterine specimens was fibroid, which was reported in 50 patients (33.78%), followed by adenomyosis which was reported in 38 patients (25.68%). About 90% of our hysterectomies were carried out through an abdominal route and 10% by the vaginal route. We reported no major complication that endanger the life of the patient as most of the complications were the usual minor postoperative ones ranging from wound infection in 9% to fever and abdominal pain in 1%. Conclusion: The vast majority of hysterectomies were performed to relieve the symptoms of pain, bleeding, or both which means that the indication can be summarized due to discomfort and inconvenience rather than threaten life. It is very clear that age has an important influence on the relative frequency of the indications which are flexible rather than absolute.

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“…A population-based analysis of practice patterns in Massachusetts revealed a fivefold variation in hysterectomy rates. 24 An international comparison of hysterectomy and other common surgical procedures in New England, England, and Norway revealed high levels of variation among highly populated regions both within the countries and between the countries. 25 Almost 30 years later, an analysis of variation in the United Kingdom continued to find a "very high" level of variation for vaginal hysterectomy and lower levels of variation for abdominal hysterectomy.…”

Section: Obstetricsmentioning

confidence: 99%

The Goldilocks Quandary of Health Care Resources

Morgan¹,

Main

Gee

2016

Obstetrics &Amp; Gynecology

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Appropriate use of health care resources is a priority for improving the quality of care. Overutilization affects almost all specialties including obstetrics and gynecology. Initiatives such as the Choosing Wisely campaign and the Joint Commission Perinatal Care Measures have brought attention to issues of overuse. The decision of these campaigns to focus on eliminating nonmedically indicated inductions before 39 weeks of gestation is an example of how more appropriate health care use can reduce complications and save millions of dollars. Cesarean delivery, hysterectomy, and prophylactic oophorectomy are procedures with high levels of variation in utilization, and the use of an intrauterine device is an example of underutilization. Efforts to promote adherence to best practices such as those directed at nonmedically indicated inductions could lead to more appropriate use of these interventions and improve women's health care.

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Variation in hysterectomy rates across small geographic areas of Massachusetts

Cited by 34 publications

References 17 publications

The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures

The Reproducibility of a Method to Identify the Overuse and Underuse of Medical Procedures

Indications for a Hysterectomy at Jordan University Hospital : A Teaching Hospital Experience

The Goldilocks Quandary of Health Care Resources

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