title: Variations in vaginal and abdominal hysterectomy by region and trust in England.
abstract: OBJECTIVE
  To examine variations between regions and hospitals in the proportion of hysterectomies performed abdominally.
  
  
  METHODS
  Analysis of routine hospital data.
  
  
  METHODS
  All National Health Service hospitals in England.
  
  
  METHODS
  Women aged 18+ hospitalised between April 1998 and March 2001.
  
  
  METHODS
  Logistic regression, adjusting for age and diagnosis.
  
  
  METHODS
  Use of the abdominal rather than the vaginal route.
  
  
  RESULTS
  The adjusted proportion of hysterectomies performed abdominally varied from 75-89% between regions, and from 25-99% between hospitals. Diagnosis accounted for nearly a third of the total variation, dwarfing the contributions of age and hospital. About two-thirds of the variation remained unaccounted for.
  
  
  CONCLUSIONS
  Despite evidence suggesting that the majority of hysterectomies may be performed vaginally, very few English trust match this.
authors.affiliation: Dr Foster Unit at Imperial, Department of Epidemiology and Piblic Health, Imperial College London, London W2 1PG, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Bottle
authors.forename: Paul
authors.initials: P
authors.lastname: Aylin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D004739:England; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007045:Hysterectomy, Vaginal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis