Variations in vaginal and abdominal hysterectomy by region and trust in England.
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.
Bottle
Alex
A
Dr Foster Unit at Imperial, Department of Epidemiology and Piblic Health, Imperial College London, London W2 1PG, UK.
Aylin
Paul
P
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