Effect of Bilateral Salpingectomy on Total Hysterectomy Cost: A National Inpatient Sample Analysis [18D]. (May 2017)

• Record Type: Journal Article
• Authors: Sheyn, David; Billow, Megan; Mahajan, Sangeeta; Soriano, Alex; El-Nashar, Sherif
• Is Part Of: Obstetrics and gynecology. Volume 129 (2017)Supplement 1
• Publication Date: 2017-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000514364.76492.8f
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Increasing prevalence of bilateral salpingectomy (BS) at time of hysterectomy has led to concern of increasing healthcare cost. A Canadian study found that salpingectomy at time of hysterectomy was associated with a lower lifetime cost than hysterectomy alone. Given the different healthcare system in Canada these findings may not apply in the United States. Our objective was to determine the cost associated with BS at time of hysterectomy based on USA healthcare data. METHODS: The 2013 National Inpatient Sample (NIS) was used to identify women over age 18 years who underwent hysterectomy with BS for benign indications. The primary outcome was higher cost defined as cost above the median. Stepwise multivariate regression analysis was used to evaluate the effect of co-variables on cost of hysterectomy. Statistical analysis was performed using JMP 10 (SAS, Carey NC). RESULTS: 18, 717 hysterectomies with BS were identified, of these 17.1% were laparoscopic, 11.2% were robotic, 58% were abdominal and 14.2% were vaginal. For all types of hysterectomy, BS was associated with a median increase in cost of $1193 ($685-$1701). For vaginal hysterectomy, the median increase in cost was $2080 ($1733-$2427). Robotic, abdominal and laparoscopic hysterectomy were all associated with an increase of less than $75 if BS was performed. Only vaginal hysterectomy was associated with a statistically significant increase in risk of hysterectomy cost being above the median (aOR = 1.57, p=0.01). CONCLUSION: Bilateral salpingectomy at time of vaginal hysterectomy is more likely to be associated with an increase in cost of hysterectomy.