The appropriateness of hysterectomy. A comparison of care in seven health plans. Health Maintenance Organization Quality of Care Consortium.
JAMA
; 269(18): 2398-402, 1993 May 12.
Article
em En
| MEDLINE
| ID: mdl-8479066
ABSTRACT
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, 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. MAIN OUTCOMEMEASURES:
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.
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Temas:
ECOS
/
Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Sistemas Pré-Pagos de Saúde
/
Revisão da Utilização de Recursos de Saúde
/
Mau Uso de Serviços de Saúde
/
Histerectomia
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
JAMA
Ano de publicação:
1993
Tipo de documento:
Article