General Obstetrics and Gynecology: Gynecology
Health care resource use for uterine fibroid tumors in the United States

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Objective

The purpose of this study was to quantify the total direct cost to the US health care system for the management of uterine leiomyomas.

Study design

We used Center for Disease Control heath care databases for estimates of inpatient care, ambulatory care, and outpatient care of leiomyomas. With International Classification of Diseases–9 codes for fibroid tumors and fibroid-related conditions, all fibroid-related care was identified in each database. Inpatient and ambulatory surgical cases were stratified by surgical procedure, and outpatient clinical cases were categorized by type of visit and health care provider. With the use of Medicare's RBRVU reimbursement rates for 2000 as a proxy for the cost of physician services and Medicare diagnostic-related group reimbursement as a proxy for facility costs, the total direct cost to the US health care system for the care of fibroid tumors was estimated.

Results

Total direct cost to treat uterine fibroid tumors was estimated at $2,151,484,847. Most of the cost was due to inpatient care, in particular, hysterectomy.

Conclusion

Uterine fibroid tumors consume a significant amount of health care resources in the United States.

Section snippets

Methods

There are several national databases that track health care use. We combined information from databases on inpatient care, ambulatory surgery, and outpatient care to estimate the total use of resources to care for fibroid tumors and to estimate the total cost to the health care system in the year 2000 to care for this condition. Because this study used existing public databases that contain only de-identified patient information, this study was exempted from Institutional Review Board

Inpatient and surgical care

Table II shows the estimates of office visits, outpatient clinical visits, and emergency department visits and of inpatient and ambulatory procedures and admissions for US women >15 years old for the years 1996 and 2000. Over the 5-year period, the total number of inpatient procedures increased by 38% (from 255,000 in 1996 to 352,500 in 2000), with hysterectomy by far the most common procedure to be performed every year. The increase in inpatient care appears to be mainly due to a 36% increase

Comment

To our knowledge, this is the first published estimation of the total disease burden of uterine fibroid tumors. Previous studies have focused on hospital costs that were associated with specific procedures.4, 7, 8, 22, 23, 24, 25, 26, 27 There is a paucity of literature concerning the total burden of fibroid tumors in the United States, and we were unable to identify any other studies that have documented the total direct cost to care for this condition, which makes comparisons difficult. In

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    Reprints not available from the authors. Address correspondence to Michael K. Flynn, MD, MHS, 601 Elmwood Avenue, Box 668, Rochester NY, 14642.

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