Randomized trial of medical treatment versus hysterectomy for abnormal uterine bleeding: Resource use in the Medicine or Surgery (Ms) trial

This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms) randomized trial. In a randomized controlled trial, we compared resources used during a 24-month follow-up period by women with abnormal uterine bleeding who were randomly assigned to either e...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2006-02, Vol.194 (2), p.332-338
Main Authors: Showstack, Jonathan, Lin, Feng, Learman, Lee A., Vittinghoff, Eric, Kuppermann, Miriam, Varner, R. Edward, Summitt, Robert L., McNeeley, S. Gene, Richter, Holly, Hulley, Stephen, Washington, A. Eugene
Format: Article
Language:English
Subjects:
Abnormal uterine bleeding
Adult
Biological and medical sciences
Costs
Diagnosis-Related Groups
Female
Gynecology. Andrology. Obstetrics
Health Resources - utilization
Humans
Hysterectomy
Hysterectomy - economics
Medical sciences
Menorrhagia - drug therapy
Menorrhagia - economics
Menorrhagia - surgery
Middle Aged
Pregnancy
Quality of Life
Relative Value Scales
Treatment Outcome
United States
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Summary:This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms) randomized trial. In a randomized controlled trial, we compared resources used during a 24-month follow-up period by women with abnormal uterine bleeding who were randomly assigned to either expanded medical treatment or hysterectomy. Women randomly assigned to hysterectomy used significantly more resources (medicine = $4479, hysterectomy = $6777; P = .03), with almost all the difference caused by the hysterectomy procedure. Fifty-three percent of women randomly assigned to medicine had a hysterectomy during the follow-up period; women who were able to continue on medical therapy had mean total resource use of $2595 compared with $6128 for medicine patients who eventually had surgery. For women with abnormal uterine bleeding refractory to cyclic medroxyprogesterone acetate, compared with expanded medical treatment, hysterectomy increases resource use significantly and results in better clinical and 6-month quality-of-life outcomes.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2005.08.014