Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Department of Obstetrics and Gynecology, Kuwait University, Kuwait City, Kuwait.
Int J Med Robot. 2020 Aug;16(4):e2107. doi: 10.1002/rcs.2107. Epub 2020 Apr 16.
We examined the association of patient factors, gynecologic diagnoses, and hospital characteristics with utilization of the robotic approach for benign hysterectomy.
We performed cross-sectional study of women (n = 725 050) undergoing hysterectomies in the 2012 to 2014 National Inpatient Sample.
A total of 725 050 women underwent inpatient hysterectomy for benign indications: 70345 (10%) were performed robotically. Women were more likely to receive robotic hysterectomy at teaching hospitals (RR 1.60 [95% CI 1.54-1.66]) after adjustment for other patient factors, gynecologic diagnoses, and hospital characteristics. They were more likely to undergo robotic hysterectomy at large (RR 1.34 [95% CI 1.29-1.39]) and for-profit hospitals (RR 1.16 [95% CI 1.11-1.22]). Women were less likely to undergo robotic hysterectomy if they were rural (RR 0.68 [95% CI 0.64-0.72]), African-American (RR 0.78 [95% CI 0.74-0.82]), or publicly insured or uninsured (RR 0.55 [95% CI 0.53-0.57]) women.
Significant geographic and hospital-level disparities exist in access to robotic hysterectomy in the United States.
我们研究了患者因素、妇科诊断和医院特征与机器人辅助良性子宫切除术应用的相关性。
我们对 2012 年至 2014 年全国住院患者样本中 725050 例接受子宫切除术的女性进行了横断面研究。
共有 725050 名女性因良性指征接受住院子宫切除术：其中 70345 例（10%）采用机器人辅助。在调整了其他患者因素、妇科诊断和医院特征后，在教学医院（RR 1.60 [95%CI 1.54-1.66]）接受机器人子宫切除术的女性更有可能。她们更有可能在大型（RR 1.34 [95%CI 1.29-1.39]）和营利性医院（RR 1.16 [95%CI 1.11-1.22]）接受机器人子宫切除术。如果女性是农村（RR 0.68 [95%CI 0.64-0.72]）、非裔美国人（RR 0.78 [95%CI 0.74-0.82]）或公共保险或无保险（RR 0.55 [95%CI 0.53-0.57]），则不太可能接受机器人子宫切除术。
在美国，获得机器人子宫切除术的机会存在显著的地域和医院层面的差异。
