Hospital-associated Costs of Chronic Pelvic Pain in Canada: A Population-based Descriptive Study.
To determine the hospital-related costs incurred by women requiring surgery or inpatient admission for chronic pelvic pain in Canada.



We conducted a population-based, cross-sectional study, focusing on women ages 15-59 with a most responsible International Classification of Diseases diagnosis of pelvic and perineal pain, dysmenorrhea, or dyspareunia who had surgery or inpatient admission with a discharge date between April 1, 2008 and March 31, 2012. This study was based on the Canadian Institute for Health Information Discharge Abstract database and the National Ambulatory Care Reporting System. Clinical diagnoses and interventions and resource intensity weights (RIW) were extracted. Hospital costs were estimated by multiplying cost per weighted case (CPWC) calculated at the national level with respective RIWs.



Over four years, there were 34 346 cases of surgery or inpatient admission for chronic pelvic pain amounting to $100.5 million with an average cost of $25 million per year. Pelvic and perineal pain accounted for 61.5% (n = 21 127) of the cases, while dysmenorrhea accounted for 31.8% (n = 10 936), and dyspareunia accounted for 6.6% (n = 2283). The vast majority of the cases (92.9%, n = 31 923) were associated with surgical interventions, with the most common surgeries being hysterectomy (47.1%, n = 16 189), followed by laparoscopy (25.8%, n = 8850), adnexal surgery (6.8%, n = 2349), and other procedures (11.6%, n = 3968).



While these estimates do not take into account non-hospital related costs, such as outpatient treatment, loss of productivity, and impact on quality of life, this study demonstrates that chronic pelvic pain represents a considerable economic burden to Canada's health care system.
Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON; Faculty of Medicine, University of Ottawa, Ottawa, ON. Electronic address: innie.chen@gmail.com.
Innie
I
Chen
Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON; Faculty of Medicine, University of Ottawa, Ottawa, ON; Institute for Clinical and Evaluative Sciences (ICES UOttawa), Ottawa, ON.
Kednapa
K
Thavorn
Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON.
Minxue
M
Shen
Faculty of Medicine, University of Ottawa, Ottawa, ON; Department of Anesthesia, University of Ottawa, Ottawa, ON.
Yvette
Y
Goddard
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC.
Paul
P
Yong
Performance Measurement & Reporting, Provincial Health Services Authority, Vancouver, BC.
George S
GS
MacRae
Performance Measurement & Reporting, Provincial Health Services Authority, Vancouver, BC.
Corrine
C
Nishi
Faculty of Medicine, University of Ottawa, Ottawa, ON.
Ayah
A
Matar
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC.
Catherine
C
Allaire
D000293:Adolescent; D000328:Adult; D002170:Canada; D059350:Chronic Pain / Q000191:economics* / Q000628:therapy; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000191:economics / Q000628:therapy; D004414:Dyspareunia / Q000191:economics* / Q000628:therapy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000191:economics*; D017048:Health Care Costs; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007044:Hysterectomy / Q000191:economics; D010535:Laparoscopy / Q000191:economics; D008875:Middle Aged; D017699:Pelvic Pain / Q000191:economics* / Q000628:therapy; D011788:Quality of Life; D055815:Young Adult
Canada; Chronic pelvic pain; economic analysis; healthcare cost