Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Trends in Utilization of Hysterectomy in US

Am J Obstet Gynecol; ePub 2017 Dec 26; Morgan, et al

Laparoscopy emerged as the most common surgical approach for hysterectomy in the US between 2010 and 2013, with outpatient hysterectomy more common than inpatient among women with commercially based insurance. This according to a study that sought to quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implications among women with commercially based insurance. A national dataset with inpatient and outpatient private insurance claims for >25 million women was used to identified hysterectomies during the study period. Researchers found:

  • 386,226 women underwent hysterectomy between 2010 and 2013.
  • Rate of utilization decreased 12.4% from 39.9 to 35.0 hysterectomies per 10,000 women.
  • The proportion of laparoscopic hysterectomies increased from 26.1% to 43.4%, with concomitant decreases in abdominal, laparoscopic assisted vaginal, and vaginal hysterectomies.
  • A shift from inpatient to outpatient surgery was also observed.
  • In each year of analysis, the average reimbursement for outpatient procedures was 44-46% less than for similar inpatient procedures.


Morgan DM, Kamdar NS, Swenson CW, Kobernik EK, Sammarco AG, Nallamothu B. Nationwide trends in the utilization of and payments for hysterectomy in the United States among commercially insured women. [Published online ahead of print December 26, 2017]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2017.12.218.

This Week's Must Reads

Prophylactic Antibiotic Use in Labor & Delivery, Obstet Gynecol; 2018 Sep; Coleman, et al

USPSTF on Screening for Cervical Cancer, JAMA; 2018 Aug 21; US Preventive Services Task Force

Prevention of Obstetric Lacerations at Vaginal Delivery, Obstet Gynecol; 2018 Sep; Cichowski, et al

Effect of Menstrual Bleeding on IUD Discontinuation, Am J Obstet Gynecol; ePub 2018 Aug 28; Hobby, et al

Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0

Must Reads in Gynecology

Uterine Weight & Complications After Hysterectomy, Am J Obstet Gynecol; ePub 2018 Jun 27; Louie, et al

New Persistent Opioid Use After Hysterectomy, Am J Obstet Gynecol; ePub 2018 Jun 18; Swenson, et al

Infection Prevention After Gynecologic Procedures, Obstet Gynecol; ePub 2018 Jun; Soper, Chelmow, et al

Treatment Update for Polycystic Ovary Syndrome, Obstet Gynecol; ePub 2018 Jun; Legro, et al

Hysterectomy Performed by Very Low-Volume Surgeons, Obstet Gynecol; ePub 2018 May 7; Ruiz, et al