Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul;130(1):130-137.
doi: 10.1097/AOG.0000000000002103.

Outpatient Hysterectomy Volume in the United States

Sarah L Cohen  1 , Mobolaji O Ajao, Nisse V Clark, Allison F Vitonis, Jon I Einarsson
Affiliations

Outpatient Hysterectomy Volume in the United States

Sarah L Cohen et al. Obstet Gynecol. 2017 Jul.

Abstract

Objective: To estimate the number of outpatient hysterectomies being performed annually in the United States in an effort to offer more correct estimates of hysterectomy use in light of reported decreasing inpatient case volume.

Methods: This is a cross-sectional analysis of State Ambulatory Surgery and Services Databases from 16 states with complete information for year 2011. Adult women undergoing hysterectomy were included. Procedure volume, route, and associated patient and surgical characteristics were calculated.

Results: There were 64,612 ambulatory hysterectomies reported; 81.5% of surgeries were performed laparoscopically and 16% vaginally. If these numbers are extrapolated to national estimates, this represents 100,000-200,000 outpatient hysterectomies per year. The strongest driver of the laparoscopic, compared with vaginal, route of hysterectomy in this data set was presence of cancer (odds ratio 4.01 [3.19-5.05], P<.001). In addition to indication for surgery, patient characteristics such as age, race, income, location, and primary payer were associated with mode of hysterectomy. The laparoscopic surgeries were associated with shorter length of stay (mean stay 0.65 days, [99% confidence interval 0.65-0.66] compared with 0.79 days [0.78-0.81], adjusted incidence rate ratio 0.89 [0.86-0.92], P<.001) and higher mean charges ($24,227 [$24,053-24,402] versus $14,068 [$13,811-14,330], P<.001) compared with vaginal surgeries.

Conclusion: The perceived decline that has been reported in national hysterectomy volume may represent lack of reporting of surgeries performed in ambulatory settings. This information has considerable implications for business, public health interventions, and insurance carriers among other key stakeholders in women's health care delivery.

PubMed Disclaimer

References

    1. Centers for Disease Control and Prevention. Key statistics from the National Survey of Family Growth. Available at: http://www.cdc.gov/nchs/nsfg/key_statistics/h/htm#hysterectomy. Retrieved January 5, 2017.
    1. Wright JD, Herzog TJ, Tsui J, Ananth CV, Lewin SN, Lu YS, et al. Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstet Gynecol 2013;122:233–41.
    1. Cohen SL, Vitonis AF, Einarssion JI. Updated hysterectomy surveillance and factors associated with minimally invasive hysterectomy. JSLS 2014;18.
    1. Wright JD, Ananth CV, Lewin SN, Burke WM, Lu YS, Neugut AI, et al. Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease. JAMA 2013;309:689–98.
    1. Schiavone MB, Herzog TJ, Ananth CV, Wilde ET, Lewin SN, Burke WM, et al. Feasibility and economic impact of same-day discharge for women who undergo laparoscopic hysterectomy. Am J Obstet Gynecol 2012;207:382.e1–9.