TY - JOUR
T1 - The Appropriateness of Hysterectomy
T2 - A Comparison of Care in Seven Health Plans
AU - The Health Maintenance Organization Quality of Care Consortium
AU - Bernstein, Steven J.
AU - McGlynn, Elizabeth A.
AU - Siu, Albert L.
AU - Roth, Carol P.
AU - Sherwood, Marjorie J.
AU - Keesey, Joan W.
AU - Kosecoff, Jacqueline
AU - Hicks, Nicholas R.
AU - Brook, Robert H.
PY - 1993/5/12
Y1 - 1993/5/12
N2 - Objective.—To develop and test a method for comparing the appropriateness of hysterectomy use in different health plans. Design.—Retrospective cohort study. Setting.—Seven managed care organizations. Patients.—Random sample of all nonemergency, nononcological hysterectomies performed in the seven managed care organizations over a 1-year period. Patients who were not continuously enrolled in a plan for 2 years prior to their hysterectomy were excluded. Main Outcome Measures.—Proportion of women undergoing hysterectomy in each plan for inappropriate clinical reasons according to ratings derived from a panel of managed care physicians. Results.—Overall, about 16% of women underwent hysterectomy for reasons judged to be clinically inappropriate. Only one plan had significantly more hysterectomies rated inappropriate compared with the group mean (27%, unadjusted). Adjusting for age and race did not affect the rankings of the plans and had little effect on the numeric results. Conclusion.—The rates of inappropriate use of hysterectomies are similar to those for other procedures and vary to a small degree among health plans. This information may be useful to purchasers when they consider which health plans to offer their employees.
AB - Objective.—To develop and test a method for comparing the appropriateness of hysterectomy use in different health plans. Design.—Retrospective cohort study. Setting.—Seven managed care organizations. Patients.—Random sample of all nonemergency, nononcological hysterectomies performed in the seven managed care organizations over a 1-year period. Patients who were not continuously enrolled in a plan for 2 years prior to their hysterectomy were excluded. Main Outcome Measures.—Proportion of women undergoing hysterectomy in each plan for inappropriate clinical reasons according to ratings derived from a panel of managed care physicians. Results.—Overall, about 16% of women underwent hysterectomy for reasons judged to be clinically inappropriate. Only one plan had significantly more hysterectomies rated inappropriate compared with the group mean (27%, unadjusted). Adjusting for age and race did not affect the rankings of the plans and had little effect on the numeric results. Conclusion.—The rates of inappropriate use of hysterectomies are similar to those for other procedures and vary to a small degree among health plans. This information may be useful to purchasers when they consider which health plans to offer their employees.
UR - http://www.scopus.com/inward/record.url?scp=0027263702&partnerID=8YFLogxK
U2 - 10.1001/jama.1993.03500180090040
DO - 10.1001/jama.1993.03500180090040
M3 - Article
C2 - 8479066
AN - SCOPUS:0027263702
SN - 0098-7484
VL - 269
SP - 2398
EP - 2402
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
IS - 18
ER -