title: A cost analysis of endometrial ablation, abdominal hysterectomy, vaginal hysterectomy, and laparoscopic-assisted vaginal hysterectomy in the treatment of primary menorrhagia.
abstract: OBJECTIVE
  To assess the cost of four procedures performed to treat primary menorrhagia.
  
  
  METHODS
  Retrospective analysis. Setting. A 394-bed womens' teaching hospital.
  
  
  METHODS
  Eighty healthy women undergoing one of the four procedures. Interventions. The study patients were equally divided among vaginal hysterectomy (VH), total abdominal hysterectomy (TAH), laparoscopic-assisted vaginal hysterectomy (LAVH), and endometrial ablation (EA).
  
  
  RESULTS
  Endometrial ablation was associated with significantly reduced hospital costs and a shorter recovery period than the other modalities. Hospital costs were less for VH and return to work was quicker after LAVH and VH. This study did not evaluate long-term failures or complications unless they occurred within the first 2 months after the procedure.
  
  
  CONCLUSIONS
  Among women who could be treated by any of these techniques, VH was significantly more cost effective for the permanent management of primary menorrhagia than LAVH and TAH. The cost efficiency of EA was clearly implied, but further studies must be completed to evaluate the long-term costs associated with treatment failures. Although physicians should not choose a procedure based exclusively on cost, the expense of a less efficient or more costly procedure may affect a hospital's competitiveness in this era of managed care.
authors.affiliation: Department of Obstetrics and Gynecology, Henry Ford Health Systems Eastern Region, 131 Kercheval, Grosse Point Farms, MI 48236, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Ransom
authors.forename: S G
authors.initials: SG
authors.lastname: McNeeley
authors.forename: C
authors.initials: C
authors.lastname: White
authors.forename: M P
authors.initials: MP
authors.lastname: Diamond
mesh_terms: D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D004564:Electrocoagulation / Q000191:economics*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007044:Hysterectomy / Q000191:economics*; D007045:Hysterectomy, Vaginal / Q000191:economics; D010535:Laparoscopy / Q000191:economics*; D007902:Length of Stay; D008595:Menorrhagia / Q000191:economics / Q000601:surgery*; D012189:Retrospective Studies