Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002.
OBJECTIVE
To analyze the impact of patient and organizational characteristics on surgical treatment patterns for patients with uterine fibroids.


METHODS
Unadjusted means and percentages were calculated from a population-based inpatient sample (HCUPNIS). Multiple logistic regression analysis was used to estimate the prevalence odds ratios for the association of uterine fibroid treatments and covariates of interest.


RESULTS
More than 1.2 million patients with a primary diagnosis of uterine fibroids were treated from 1998 to 2002. Of these, 84.4% received a hysterectomy and 12.3% received a myomectomy. Total abdominal hysterectomy was the most common procedure. The number of supracervical hysterectomies increased 18.1% over the five-year period. Black women and Asians/Pacific Islanders were more likely than white women to receive a myomectomy. All types of hysterectomies were more common in Medicaid patients compared with private/HMO patients. With the exception of patients in ZIP codes with a median income of <$25,000 per year, an inverse relationship was identified between income and hysterectomy rates.


CONCLUSIONS
The management of uterine fibroids appears to differ across a variety of socioeconomic factors and institutional characteristics. This study suggests that additional research should be conducted to assess the impact of nonclinical factors on treatment decisions for patients with uterine fibroids.
Becker
Edmund R
ER
Rollins School of Public Health, Room 630, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA. ebeck01@sph.emory.edu
Spalding
James
J
DuChane
Janeen
J
Horowitz
Ira R
IR
D000328:Adult; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data*; D019458:Insurance Coverage; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000208:ethnology / Q000601:surgery*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000208:ethnology / Q000601:surgery*