title: [Development of technicality indices of hysterectomies in Quebec].
abstract: OBJECTIVE
  Assess the evolution of the technicity index for hysterectomies in Québec.
  
  
  METHODS
  We used the ADAM ( Analyse en direct des actes médicaux) database to determine the number of hysterectomies done each year within 79 hospitals in Québec from 2002 to 2009. Excluding oncologically indicated surgeries, we calculated the number of hysteretomies and the proportion performed by the vaginal route (laparoscopically assisted or not), by laparoscopu, and by laparotomy for each study year.
  
  
  RESULTS
  We obtained complete data fo 67 (85%) of 79 hospitals, for a total of 74 210 (94%) of 79 305 hysterectomies done. We observed a decline in the total number of hysterestomies from 12 860 in 2002-2003 to 8010 in 2008-2009 (P<0.001) Furthermore, the proportion of hysterectomies done by laparoscopy increased, the proportion of vaginal hysterectomies remained stable, and the proportion of hysterectomies done by laparoscopy increased. For all of Québec, the technicity index increased from 39.9% in 2002-2003 to 44.3% in 2008-2009 (P<0.001).
  
  
  CONCLUSIONS
  The number of hysterectomies is declining and the technicity index is increasing in Quebec. We believe that this can be attributed to an increased use of medical alternatives and the presence of gynaecologists better trained in advanced laparoscopic surgery.
authors.affiliation: Département d'obstétrique et de gynécologie, Faculté de médecine, Université Laval, Québec (Québec).
authors.forename: Sarah-Maude
authors.initials: SM
authors.lastname: Bernatchez-Laflamme
authors.affiliation: Département d'obstétrique et de gynécologie, Faculté de médecine, Université Laval, Québec (Québec); Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec (Québec).
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bujold
authors.affiliation: Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec (Québec).
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Roberge
authors.affiliation: Département d'obstétrique et de gynécologie, Faculté de médecine, Université Laval, Québec (Québec).
authors.forename: Philippe Y
authors.initials: PY
authors.lastname: Laberge
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000706:statistics & numerical data*; D007045:Hysterectomy, Vaginal / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000706:statistics & numerical data; D007813:Laparotomy / Q000706:statistics & numerical data; D011792:Quebec