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

Academic Article

Abstract

  • OBJECTIVE: This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms) randomized trial. STUDY DESIGN: 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. RESULTS: 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. CONCLUSION: 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.
  • Authors

    Keywords

  • Adult, Diagnosis-Related Groups, Female, Health Resources, Humans, Hysterectomy, Menorrhagia, Middle Aged, Pregnancy, Quality of Life, Relative Value Scales, Treatment Outcome, United States
  • Digital Object Identifier (doi)

    Authorlist

  • Showstack J; Lin F; Learman LA; Vittinghoff E; Kuppermann M; Varner RE; Summitt RL; McNeeley SG; Richter H; Hulley S
  • Start Page

  • 332
  • End Page

  • 338
  • Volume

  • 194
  • Issue

  • 2