From the Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, CT.
Female Pelvic Med Reconstr Surg. 2021 Jan 1;27(1):e177-e179. doi: 10.1097/SPV.0000000000000877.
We aim to describe the volume and cost of female pelvic reconstructive surgeries across the United States and evaluate the relationship between volume and cost of inpatient care for these surgeries.
Medicare Severity Diagnosis Related Group was used to identify admissions for female pelvic reconstructive procedures and aggregated at the state and census region levels using the 2016 Inpatient Medicare Provider Utilization and Payment Data. Total hospital charges were converted to cost using the cost-to-charge ratios for each state. For context and comparison with another benign gynecologic procedure, we replicated the analysis for benign uterine and adnexal surgeries.
We identified 2133 patients admitted for female pelvic reconstructive procedures. Across all states, the average cost was US $11,857, and the average number of procedures per 100,000 Medicare beneficiaries was 4.4. The Northeast had the lowest cost, and the West had the highest. The regression model showed that, for each additional admission per 100,000 Medicare beneficiaries, the cost of inpatient care decreased (US $549, P = 0.04). In comparison, we identified 8340 admissions for benign uterine and adnexal surgeries and found a minimal, nonsignificant decrease in cost for each additional admission.
There are variations in the volume and cost of admissions for female pelvic reconstructive surgeries across the United States. We identified that an inverse association between volume and cost for female pelvic reconstructive surgery was not seen in benign uterine and adnexal surgeries.
我们旨在描述美国女性盆底重建手术的数量和费用，并评估这些手术住院护理量与成本之间的关系。
使用医疗保险严重程度诊断相关组（Medicare Severity Diagnosis Related Group）来识别女性盆底重建手术的入院情况，并使用 2016 年住院医疗保险提供者使用和支付数据按州和人口普查区域进行汇总。使用每个州的费用与收费比率将总住院费用转换为成本。为了提供背景信息并与另一种良性妇科手术进行比较，我们对良性子宫和附件手术进行了重复分析。
我们确定了 2133 名接受女性盆底重建手术的患者。在所有州中，平均成本为 11857 美元，每 10 万 Medicare 受益人的手术平均数量为 4.4 次。东北地区的成本最低，西部地区的成本最高。回归模型显示，每增加 10 万 Medicare 受益人的住院人数，住院护理费用就会降低（549 美元，P = 0.04）。相比之下，我们确定了 8340 例良性子宫和附件手术的入院病例，发现每增加一次入院，成本仅略有下降，无统计学意义。
美国女性盆底重建手术的入院数量和费用存在差异。我们发现，女性盆底重建手术的量与成本之间呈反比关系，而良性子宫和附件手术则不存在这种关系。
