title: Patient clinical factors influencing use of hysterectomy in New York, 2001-2005.
abstract: OBJECTIVE
  To determine the effect of patient clinical factors on the utilization of hysterectomy and alternatives of hysterectomy.
  
  
  METHODS
  The database of Empire Blue Cross Blue Shield was abstracted for all claims relating to a hysterectomy procedure or a hysterectomy-associated diagnosis during the 48 consecutive months of May 2001-April 2005. Two hundred ninety-five thousand one hundred forty-eight claim lines were abstracted and analyzed by CPT and diagnostic grouping codes.
  
  
  RESULTS
  One thousand nine hundred seventy-two hysterectomies were performed during the time analyzed, and 5,077 hysterectomy alternatives. The mean age of all patients encountered was 39.1 years. Patients undergoing a hysterectomy alternative or hysterectomy had mean ages of 46.0 and 49.7 years, respectively. Abnormal bleeding was associated with the most encounters, while leiomyomata was associated with the most hysterectomies performed.
  
  
  CONCLUSIONS
  Patients who undergo hysterectomy are, on average, older than those undergoing office management or hysterectomy alternatives. Procedures are most commonly associated with diagnosis of bleeding, leiomyomata, or cancer. Bleeding typically results in a hysterectomy alternative, while leiomyomata has the highest association with hysterectomy.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Medical Center, New York, NY 10029, USA. herb.gretz@mssm.edu
authors.forename: Herbert
authors.initials: H
authors.lastname: Gretz
authors.forename: William H
authors.initials: WH
authors.lastname: Bradley
authors.forename: Konstantin
authors.initials: K
authors.lastname: Zakashansky
authors.forename: Farr
authors.initials: F
authors.lastname: Nezhat
authors.forename: Jamal
authors.initials: J
authors.lastname: Rahaman
authors.forename: Linus
authors.initials: L
authors.lastname: Chuang
authors.forename: Deborah Loeb
authors.initials: DL
authors.lastname: Bohren
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kreiger
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rubin
authors.forename: Alan
authors.initials: A
authors.lastname: Sokolow
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D009518:New York; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D019233:Retreatment / Q000706:statistics & numerical data; D014592:Uterine Hemorrhage / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery