Analyses of Length of Hospital Stay and Expenses Associated with Hysterectomy_Chinese Journal of Evidence-Based Medicine

Authors：

TAN Xianjie , HU Bingshui , LANG Jinghe

Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China;

Corresponding author：

Keywords：

Hysterectomy; Surgical approach; Length of hospital stay; Expense

DOI：

10.7507/1672-2531.20080146

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Objective 　To examine the length of hospital stay and expenses associated with hysterectomy in China and to compare the results with those from developed counties, so as to provide comparative information about hysterectomy in China.
Methods 　Hospital discharge data on hysterectomies performed in Peking Union Medical College Hospital from 2002 to 2006 were retrieved. The cases were classified into 3 groups, namely abdominal, laparoscopic and vaginal hysterectomy. The length of hospital stay and expenses associated with hysterectomy were analyzed retrospectively.
Results 　Records of 5975 women who underwent hysterectomies were analyzed, including 3295 cases (65.7%) of abdominal hysterectomy, 1543 (25.8%) cases of laparoscopic hysterectomy (25.8%) and 507 (8.5%) cases of vaginal hysterectomy. The median (mean) postoperative length of stay were 6 (6.4) days, 4 (4.8) days and 5 (5.6) days in the abdominal, laparoscopic and vaginal hysterectomy groups, respectively. These were approximately 2 days longer than those in developed countries. The median total expenses were 6109.0, 7296.3 and 5265.2 RMB in the abdominal, laparoscopic and vaginal hysterectomy groups, respectively. After adjustment for the differences in Gross National Income (GNI) per capita between China and developed countries, the expenses associated with hysterectomy in China were 8.7 and 1.8-4.9 times higher than those in UK and USA, respectively.
Conclusion 　Compared with abdominal and vaginal hysterectomies, laparoscopic hysterectomy is associated with a shorter postoperative length of stay, but with higher hospital cost. Compared with developed countries, hysterectomy is actually more expensive and associated with a longer hospital stay in China.

Citation： TAN Xianjie,HU Bingshui,LANG Jinghe. Analyses of Length of Hospital Stay and Expenses Associated with Hysterectomy. Chinese Journal of Evidence-Based Medicine, 2008, 08(8): 637-641. doi: 10.7507/1672-2531.20080146 Copy

1.	Reich H. Laprooscopic hysterectomy. Surg Laparosc Endos, 1992, 5(1): 85-88.
2.	Sculpher M, Manca A, Abbott J, et al. Cost effectiveness analysis of laparoscopic hysterectomy compared with standard hysterectomy: results from a randomised trial. BMJ, 2004, 328(7432): 134-139.
3.	Lenihan JP, Kovanda C, Cammarano C. Comparison of laparoscopic-assisted vaginal hysterectomy with traditional hysterectomy for cost-effectiveness to employers. Am J Obstet Gynecol, 2004, 190(6): 1714-1720.
4.	Campbell ES, Xiao H, Smith MK. Types of hysterectomy. Comparison of characteristics, hospital costs, utilization and outcomes. J Reprod Med, 2003, 48(12): 943-949.
5.	Dorsey JH, Holtz PM, Griffiths RI, et al. Costs and charges associated with three alternative techniques of hysterectomy. N Engl J Med, 1996, 335(7): 476-482.
6.	谭先杰, 郎景和, 沈铿, 等. 4180例子宫切除术的手术途、手术适应证和卫生经济学初步分析. 中国医学科学院学报, 2003, 25(4): 406-409.
7.	Johnson N, Barlow D, Lethaby A, et al. Methods of hysterectomy: systematic review and meta-analysis of randomized controlled trials. BMJ, 2005, 330(7506): 1478-1485.
8.	Matteson KA, Peipert JF, Hirway P, et al. Factors associated with increased charges for hysterectomy. Obstet Gynecol, 2006, 107(5): 1057-1063.
9.	Claerhout F, Deprest J. Laparoscopic hysterectomy for benign diseases. Best Pract Res Clin Obstet Gynaecol, 2005, 19(3): 357-375.

1. Reich H. Laprooscopic hysterectomy. Surg Laparosc Endos, 1992, 5(1): 85-88.
2. Sculpher M, Manca A, Abbott J, et al. Cost effectiveness analysis of laparoscopic hysterectomy compared with standard hysterectomy: results from a randomised trial. BMJ, 2004, 328(7432): 134-139.
3. Lenihan JP, Kovanda C, Cammarano C. Comparison of laparoscopic-assisted vaginal hysterectomy with traditional hysterectomy for cost-effectiveness to employers. Am J Obstet Gynecol, 2004, 190(6): 1714-1720.
4. Campbell ES, Xiao H, Smith MK. Types of hysterectomy. Comparison of characteristics, hospital costs, utilization and outcomes. J Reprod Med, 2003, 48(12): 943-949.
5. Dorsey JH, Holtz PM, Griffiths RI, et al. Costs and charges associated with three alternative techniques of hysterectomy. N Engl J Med, 1996, 335(7): 476-482.
6. 谭先杰, 郎景和, 沈铿, 等. 4180例子宫切除术的手术途、手术适应证和卫生经济学初步分析. 中国医学科学院学报, 2003, 25(4): 406-409.
7. Johnson N, Barlow D, Lethaby A, et al. Methods of hysterectomy: systematic review and meta-analysis of randomized controlled trials. BMJ, 2005, 330(7506): 1478-1485.
8. Matteson KA, Peipert JF, Hirway P, et al. Factors associated with increased charges for hysterectomy. Obstet Gynecol, 2006, 107(5): 1057-1063.
9. Claerhout F, Deprest J. Laparoscopic hysterectomy for benign diseases. Best Pract Res Clin Obstet Gynaecol, 2005, 19(3): 357-375.

Chinese Journal of Evidence-Based Medicine

Analyses of Length of Hospital Stay and Expenses Associated with Hysterectomy

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