Retrospective database analysis of clinical outcomes and costs for treatment of abnormal uterine bleeding among women enrolled in US Medicaid programs

Women with abnormal uterine bleeding (AUB) may be treated surgically with hysterectomy or global endometrial ablation (GEA), an outpatient procedure. We compared the costs and clinical outcomes of these surgical procedures for AUB among women in Medicaid programs. The Truven Health MarketScan(®) Med...

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Bibliographic Details
Published in:ClinicoEconomics and outcomes research 2014-01, Vol.6 (default), p.423-429
Main Authors: Bonafede, Machaon M, Miller, Jeffrey D, Laughlin-Tommaso, Shannon K, Lukes, Andrea S, Meyer, Nicole M, Lenhart, Gregory M
Format: Article
Language:English
Subjects:
Clinical outcomes
Comparative analysis
Drug therapy
Economic aspects
Gynecology
Health care expenditures
Health care policy
Health insurance
Hysterectomy
Insurance coverage
Medicaid
Medical economics
Medical research
Medicare
Menopause
Menstruation
Nonsteroidal anti-inflammatory drugs
Original Research
Patient outcomes
Patient satisfaction
Prescription drugs
Studies
Uninsured people
Uterine hemorrhage
Women's health
Womens health
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Description
Summary:Women with abnormal uterine bleeding (AUB) may be treated surgically with hysterectomy or global endometrial ablation (GEA), an outpatient procedure. We compared the costs and clinical outcomes of these surgical procedures for AUB among women in Medicaid programs. The Truven Health MarketScan(®) Medicaid Multi-State Database was used to identify Medicaid women aged 30-55 years with AUB who newly initiated GEA or hysterectomy (index event) during 2006-2010. Patients were required to have 12 months of continuous enrollment pre-index and post-index. Baseline characteristics were assessed in the pre-index period; health care utilization and costs (2011 USD), treatment complications, and reinterventions were assessed in the post-index period. Of 1,880 women who met the study criteria (mean age 40.7 years), 53.4% were Caucasian, 33.1% were African-American, and 2.3% were Hispanic; many (42.8%) received their Medicaid eligibility due to disability. Similar proportions received GEA (50.9%) or hysterectomy (49.1%). At baseline, both groups also had similar Deyo-Charlson Comorbidity scores (0.65), and use of antibiotics (69.4%), nonsteroidal anti-inflammatory drugs (56.3%), and oral contraceptives (5.3%). More hysterectomy patients than GEA patients had a treatment-related complication (52% versus 36%, respectively, P
ISSN:1178-6981
1178-6981
DOI:10.2147/CEOR.S67888