Hysterectomy – Clinical and Economic Outcomes

Cost of Hysterectomy + Clinical Outcomes

A study of patients showed that there was a 65% reduction in readmissions of women who had a minimally invasive hysterectomy versus those who had a traditional "open" procedure.41 The study also showed there was a 50% reduction in nosocomial infection rate.41 During a traditional approach, a large incision is made across the abdomen, leaving a large scar. But with a minimally invasive hysterectomy, which only requires small ¾-inch incisions, there is significantly less scarring or no scarring at all. In general, when compared with patients treated with a total abdominal hysterectomy, women who undergo a hysterectomy using minimally invasive techniques can usually expect:

  • Less blood loss.63
  • Fewer complications and infections.63
  • Shorter hospital stays.20
  • Faster recovery and return to normal activities.20

Risks

There are risks with any surgery, such as adverse reactions to medications, problems with anesthesia, problems breathing, bleeding, blood clots, inadvertent injury to nearby organs and blood vessels, even death. The procedure to remove the uterus (hysterectomy) has its own risks, including wound infection with possible abscess formation, pneumonia, nerve injury, and post-operative opening of the area where the vagina was closed. Patients should consult their physicians to determine if this procedure is appropriate for their condition

Economic outcomes

Minimally invasive techniques for hysterectomies benefit employers and health plans by lowering overall expenditures. While an open hysterectomy costs an average of $11,739 in a hospital setting, an outpatient laparoscopic hysterectomy is $9,426 and vaginal hysterectomy only $7,627.63

With minimally invasive surgery for hysterectomy, payors may have an opportunity to improve quality while also lowering expenditures. While patients may benefit from a better overall medical experience, the key advantage of minimally invasive procedures for employers and health plans is the quicker recovery period. A meta-analysis reported that minimally invasive, laparoscopic assisted surgeries compared to abdominal hysterectomy reduced:

  • Length of stay (LOS) time by a range of one to four days.20
  • Return to work time by a range of 14.91 to 28 days.20

And minimally invasive vaginal hysterectomies reduced:20

  • LOS time by a range of 0.3 to 1.5 days.
  • Return to work time by an average of 6.51 days.
  • Return to normal activities by an average of 3.15 days.

Addressing the needs of the working family

Many of the working women who undergo hysterectomies using minimally invasive techniques are able resume normal function at home and at work sooner than traditional abdominal hysterectomy.

As for working family members of the patient, many must use Family and Medical Leave Act benefits or personal time to stay home and assist during recuperation. But family members of minimally invasive hysterectomy patients can often take fewer days off and return to work sooner because of a quicker recovery.54

  • Open abdominal hysterectomy patients' families take an average of 4.63 days off.
  • Minimally invasive, laparoscopic-assisted hysterectomy patients’ families take an average of 2.38 days off.
Faster recovery chartLess time off work chart
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