Cost of pelvic organ prolapse surgery in the United States.
OBJECTIVE
To estimate the annual direct cost to society of pelvic organ prolapse operations in the United States.


METHODS
We multiplied the number of pelvic organ prolapse operations identified in the 1997 National Hospital Discharge Survey by national average Medicare reimbursement for physician services and hospitalizations. Although this reimbursement does not estimate the actual cost, it is a proxy for cost, which estimates what society pays for the procedures.


RESULTS
In 1997, direct costs of pelvic organ prolapse surgery were 1012 million dollars (95% confidence interval [CI] 775 dollars, 1251 million), including 494 dollars million (49%) for vaginal hysterectomy, 279 million dollars (28%) for cystocele and rectocele repair, and 135 million dollars (13%) for abdominal hysterectomy. Physician services accounted for 29% (298 million dollars) of total costs, and hospitalization accounted for 71% (714 million dollars). Twenty-one percent of pelvic organ prolapse operations included urinary incontinence procedures (218 million dollars). If all operations were reimbursed by non-Medicare sources, the annual estimated cost would increase by 52% to 1543 million dollars.


CONCLUSIONS
The annual direct costs of operations for pelvic organ prolapse are substantial.
Subak
L L
LL
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, Mount Zion Women's Health, San Francisco, California 94143-1688, USA. subakl@obgyn.ucsf.edu
Waetjen
L E
LE
van den Eeden
S
S
Thom
D H
DH
Vittinghoff
E
E
Brown
J S
JS
D004180:Direct Service Costs / Q000706:statistics & numerical data*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay / Q000191:economics; D006278:Medicare; D020047:Rectocele / Q000191:economics* / Q000601:surgery; D014481:United States; D001745:Urinary Bladder Diseases / Q000191:economics* / Q000601:surgery; D014596:Uterine Prolapse / Q000191:economics* / Q000601:surgery