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Related Experiment Videos

The effect of a second opinion program on hysterectomy performance.

M L Finkel1, D J Finkel

  • 1Cornell University Medical College, Department of Public Health, New York, NY 10021.

Medical Care
|September 1, 1990
PubMed
Summary

Regional differences in hysterectomy rates persist, with some women undergoing surgery even when not medically confirmed. This highlights potential overuse of hysterectomy in certain areas.

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Area of Science:

  • Gynecology
  • Health Services Research
  • Public Health

Background:

  • Hysterectomy rates exhibit significant regional disparities.
  • Concerns exist regarding potentially unnecessary surgeries due to unexplained variations.
  • Gynecologic need alone does not account for these regional differences.

Purpose of the Study:

  • To investigate regional variations in hysterectomy rates.
  • To analyze second opinion confirmation rates for elective hysterectomy.
  • To identify factors contributing to unnecessary surgeries.

Main Methods:

  • Retrospective analysis of women insured in 1987 requiring a second opinion for elective hysterectomy.
  • Inclusion of 1,698 women referred for a second opinion.

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  • Analysis of a random sample of 135 women whose surgery was not confirmed.

    • Main Results:

    • Confirmation rates for hysterectomy did not significantly vary by region.
    • Surgical rates among unconfirmed cases showed regional variation.
    • Women in the Northeast were less likely to proceed with surgery post-confirmation denial.
    • Women in the South and North Central regions were more likely to proceed with surgery despite non-confirmation.

    Conclusions:

    • Regional variations in hysterectomy rates are influenced by factors beyond medical necessity.
    • Some hysterectomies are performed for questionable indications, including inadequate symptoms or lack of pathologic justification.
    • Further research is needed to address and mitigate unnecessary hysterectomies in specific regions.