A cohort analysis of pre-menopausal women with dysfunctional uterine bleeding.
OBJECTIVE
To examine the clinical and cost outcomes of patients with dysfunctional uterine bleeding (DUB) who are treated with hysterectomy or not.


METHODS
A retrospective analysis of DUB patients over 30 months of treatment after initial diagnosis.


METHODS
Patients with DUB from an HMO with over 200,000 enrollees.


METHODS
Study patients, all women with an initial diagnosis of DUB, were divided into two cohorts. Cohort 1 was women who had a hysterectomy (not for cancer); Cohort 2 was women who did not have a hysterectomy.


METHODS
Visit counts and costs, prescription counts and costs, hospital costs, and procedure counts.


RESULTS
Hysterectomy patients in our dataset tend to have more prescriptions, higher prescription costs, more visits overall, higher visit costs, higher hospitalization costs, and higher total costs per member per month (PMPM) than non-hysterectomy patients. After surgery, the hysterectomy patients' costs and utilization PMPM are higher than those for the non-hysterectomy patients.


CONCLUSIONS
There is wide variation in the treatment of patients with DUB. Clinical practice improvement studies are needed to determine the appropriate treatments based on patient characteristics to achieve better outcomes for lower costs.
Horn
S D
SD
Institute for Clinical Outcomes Research (ICOR), Salt Lake City, UT 84109, USA.
Prather
S
S
Jones
C A
CA
D000328:Adult; D000928:Antidepressive Agents / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D017281:Cost of Illness; D016527:Drug Costs; D005260:Female; D012739:Gonadal Steroid Hormones / Q000191:economics / Q000627:therapeutic use; D006279:Health Maintenance Organizations; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D009819:Office Visits; D017063:Outcome Assessment, Health Care; D017697:Premenopause; D012189:Retrospective Studies; D014481:United States; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*