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Research Letter |

Trends in Inpatient and Outpatient Hysterectomy and Oophorectomy Rates Among Commercially Insured Women in the United States, 2000-2014

Kemi M. Doll, MD1,2; Stacie B. Dusetzina, PhD1,2,3,4; Whitney Robinson, PhD2,5,6
[+] Author Affiliations
1Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
3Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
4Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina
5Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
6Carolina Population Center, University of North Carolina at Chapel Hill
JAMA Surg. 2016;151(9):876-877. doi:10.1001/jamasurg.2016.0804.
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This study analyzes the trends in inpatient and outpatient hysterectomy and oophorectomy rates among commercially insured women in the United States from 2000 to 2014.

A hysterectomy is the second most common surgical procedure among women in the United States, with approximately 600 000 performed annually for benign gynecologic conditions.1 Trends in hysterectomy rates are an important marker for innovation and quality in gynecology as treatment alternatives increase and as evidence of the underuse of these treatment alternatives emerges.2 The accurate identification of a hysterectomy requires capturing data from both inpatient and outpatient services, given the shifting setting of care over recent years. Yet, the highest-quality national trend estimates have been significantly limited by the exclusion of data on outpatient procedures due to the use of databases restricted to inpatient settings.3,4 Prior studies that included inpatient and outpatient settings have focused on small geographic areas only, limiting their generalizability.5 The lack of national outpatient data is a critical gap because the rapid dissemination of robotic surgery has likely shifted the proportion of hysterectomies that are performed in outpatient settings.

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Figure 1.
Hysterectomy Rates Among Women 18 to 64 Years of Age Enrolled in Commercial Health Plans, 2000-2014

Data are from the Truven Health Analytics Commercial Claims and Encounters Database. To calculate the annual rates, we divided the number of women receiving a hysterectomy by the total number of women who were enrolled in the health plans in each month and multiplied this value by 100 000 to represent the rate per 100 000 health plan enrollees.

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Figure 2.
Oophorectomy Rates Among Women 18 to 64 Years of Age Enrolled in Commercial Health Plans, 2000-2014

Data are from the Truven Health Analytics Commercial Claims and Encounters Database. To calculate the annual rates, we divided the number of women receiving an oophorectomy by the total number of women who were enrolled in the health plans in each month and multiplied this value by 100 000 to represent the rate per 100 000 health plan enrollees.

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