The appropriateness of hysterectomy. A comparison of care in seven health plans. Health Maintenance Organization Quality of Care Consortium

To develop and test a method for comparing the appropriateness of hysterectomy use in different health plans. Retrospective cohort study. Seven managed care organizations. Random sample of all nonemergency, non-oncological hysterectomies performed in the seven managed care organizations over a 1-yea...

Full description

Saved in:
Bibliographic Details
Published inJAMA : the journal of the American Medical Association Vol. 269; no. 18; p. 2398
Main Authors Bernstein, S J, McGlynn, E A, Siu, A L, Roth, C P, Sherwood, M J, Keesey, J W, Kosecoff, J, Hicks, N R, Brook, R H
Format Journal Article
LanguageEnglish
Published United States 12.05.1993
Subjects
Adult
Aged
Female
Health Maintenance Organizations - standards
Health Maintenance Organizations - statistics & numerical data
Health Services Misuse - statistics & numerical data
Health Services Research - organization & administration
Humans
Hysterectomy - statistics & numerical data
Middle Aged
Quality Assurance, Health Care
Retrospective Studies
United States
Utilization Review - statistics & numerical data
Online AccessGet more information

Cover

More Information
Summary:To develop and test a method for comparing the appropriateness of hysterectomy use in different health plans. Retrospective cohort study. Seven managed care organizations. Random sample of all nonemergency, non-oncological 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. Proportion of women undergoing hysterectomy in each plan for inappropriate clinical reasons according to ratings derived from a panel of managed care physicians. 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. 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.
ISSN:0098-7484