Elsevier

Obstetrics & Gynecology

Volume 98, Issue 4, October 2001, Pages 646-651
Obstetrics & Gynecology

Cost of pelvic organ prolapse surgery in the United States

https://doi.org/10.1016/S0029-7844(01)01472-7Get rights and content

Abstract

OBJECTIVE:

To estimate the annual direct cost to society of pelvic organ prolapse operations in the United States.

METHODS:

We multiplied the number of pelvic organ prolapse operations identified in the 1997 National Hospital Discharge Survey by national average Medicare reimbursement for physician services and hospitalizations. Although this reimbursement does not estimate the actual cost, it is a proxy for cost, which estimates what society pays for the procedures.

RESULTS:

In 1997, direct costs of pelvic organ prolapse surgery were $1012 million (95% confidence interval [CI] $775, 1251 million), including $494 million (49%) for vaginal hysterectomy, $279 million (28%) for cystocele and rectocele repair, and $135 million (13%) for abdominal hysterectomy. Physician services accounted for 29% ($298 million) of total costs, and hospitalization accounted for 71% ($714 million). Twenty-one percent of pelvic organ prolapse operations included urinary incontinence procedures ($218 million). If all operations were reimbursed by non-Medicare sources, the annual estimated cost would increase by 52% to $1543 million.

CONCLUSION:

The annual direct costs of operations for pelvic organ prolapse are substantial.

Section snippets

Materials and methods

We estimated the annual direct cost of prolapse operations in the United States by multiplying the number of pelvic organ prolapse operations by the direct medical costs per surgery (unit costs). The 1997 National Hospital Discharge Survey database was used to estimate the annual number of pelvic organ prolapse operations in the United States.3 In brief, the National Hospital Discharge Survey estimates national hospital discharges using a sample of nonfederal, short-stay hospitals nationwide.

Results

In 1997, an estimated 354,962 (95% CI 317,076, 392,356) pelvic organ prolapse operations were performed on 225,964 (95% CI 200,017, 251,911) women in the United States (Table 2). Women had a mean age of 54.6 years (± standard deviation [SD] 15.2), and 31% were over 65 years. The most common procedure performed was hysterectomy (N = 130,731; 58% of total prolapse operations), with vaginal hysterectomy (N = 103,317; 79%) performed more often than abdominal hysterectomy (N = 27,414; 21%) (Table 2)

Discussion

The annual cost of surgery for pelvic organ prolapse in the United States was estimated as $1012 million (95% CI $775, $1251 million), comparable with the annual estimated direct costs of other common specific interventions (operations and hospitalizations) and ongoing disease management for prevalent health problems in women (Table 4). 8, 9, 10, 11, 12

Pelvic organ prolapse is a common problem, with a lifetime prevalence of 30–50%.1 Because 2% of women are symptomatic with pelvic organ

References (15)

There are more references available in the full text version of this article.

Cited by (0)

Dr. Subak is a Women’s Reproductive Health Research Scholar supported by the National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland (K12 HD01262-02). Dr. Brown is supported by grant 1K08AG00710-01A1 from the National Institute on Aging, National Institutes of Health, Bethesda, Maryland.

View full text