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Dilatation and curettage: praxeology
David Cumming1, Arif Alibhai, Danny Robson
1Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, AB, Canada.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|November 6, 2002
Summary
Dilatation and curettage (D&C) utilization varied significantly across Alberta
Area of Science:
- Gynecology
- Reproductive Health
- Healthcare Management
Background:
- Dilatation and curettage (D&C) is a common gynecological procedure.
- It is used for managing early pregnancy loss and abnormal uterine bleeding.
- Understanding regional variations in D&C use is crucial for healthcare planning.
Purpose of the Study:
- To analyze variations in inpatient and outpatient D&C rates.
- To compare D&C utilization for early pregnancy loss and abnormal uterine bleeding.
- To examine these variations across 17 health regions in Alberta.
Main Methods:
- A cohort study of 1.36 million women in Alberta was analyzed.
- Inclusion criteria: D&C for early pregnancy loss or abnormal uterine bleeding.
- Statistical analysis examined frequency variations among health regions.
Main Results:
- A 4-fold variation in D&C rates for pregnancy loss was observed between age groups.
- Abnormal uterine bleeding showed up to a 5-fold variation in D&C rates across regions.
- Significant regional and urban-rural disparities in D&C frequency were identified.
Conclusions:
- Substantial variations in D&C utilization exist in Alberta, suggesting physician preference.
- Outpatient procedures show high variation, indicating potential for reduced inpatient rates.
- Re-evaluation of D&C's role is warranted, considering costs compared to alternative procedures.