title: [Analysis from the French DRG-based information system (PMSI) of conservative surgical treatment for abnormal uterine bleeding in 2008-2010].
abstract: OBJECTIVE
  To evaluate the conservative surgical treatment for abnormal uterine bleeding from the Medicalized Information System Program (PMSI).
  
  
  METHODS
  The diagnosis codes were selected from 10th version of the international classification disease. A transversal and longitudinal descriptive analysis was performed from hospital stays, patient's characteristics, medical procedures between 2008-2010.
  
  
  RESULTS
  Nineteen thousand six hundred and seventy-nine patients were admitted in hospital (public or private) for treatment of abnormal uterine bleeding. Endometrial ablation increased by 16,7%, 10.2% for first generation technique (G1) and 63.5% for second generation techniques (G2). G2 were used in 15% of indications. The median age was respectively 45.2±6.4 years old versus 45.8±4.9 years old for G2. The median length of hospital stay was 1.6 ±1with 69% of patients in ambulatory care. The likelihood to have a hysterectomy in the 3 years follow-up was higher after G1 than G2 treatments (P=0.0034) for the patients above 40 years old. In longitudinal study, defined only by endometrial hyperplasia, 11,532 patients were included and only 8.2% had been treated by G2.
  
  
  CONCLUSIONS
  In spite of the international guidelines since 2008, 85% of patients treated with first generation surgical technique. The failure rate defined by a re-ablation or a hysterectomy is higher after G1. This result must be discussed in relationship with cost effective aspects.
authors.affiliation: Service gynécologie obstétrique, CHU Bicêtre, AP-HP, 78, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; CESP-Inserm U1018, reproduction et développement de l'enfant, 82, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France. Electronic address: herve.fernandez@bct.aphp.fr.
authors.forename: H
authors.initials: H
authors.lastname: Fernandez
authors.affiliation: Service gynécologie obstétrique, centre hospitalier René-Dubos, 6, avenue de l'Île-de-France, 95303 Cergy-Pontoise, France.
authors.forename: V
authors.initials: V
authors.lastname: Villefranque
authors.affiliation: Service gynécologie obstétrique, centre hospitalier Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
authors.forename: P
authors.initials: P
authors.lastname: Panel
mesh_terms: D000328:Adult; D055356:Endometrial Ablation Techniques / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D013509:Gynecologic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data*; D014592:Uterine Hemorrhage / Q000601:surgery*
keywords: Ambulatory care; Chirurgie ambulatoire; Deuxième génération; First generation; Hémorragie utérine; Information system databases; PMSI; Première génération; Second generation; Uterine bleeding