A cohort analysis of pre-menopausal women with dysfunctional uterine bleeding.

Abstract

Objective: To examine the clinical and cost outcomes of patients with dysfunctional uterine bleeding (DUB) who are treated with hysterectomy or not.

Design: A retrospective analysis of DUB patients over 30 months of treatment after initial diagnosis.

Setting: Patients with DUB from an HMO with over 200,000 enrollees.

Participants: Study patients, all women with an initial diagnosis of DUB, were divided into two cohorts. Cohort 1 was women who had a hysterectomy (not for cancer); Cohort 2 was women who did not have a hysterectomy.

Main outcome measures: Visit counts and costs, prescription counts and costs, hospital costs, and procedure counts.

Results: Hysterectomy patients in our dataset tend to have more prescriptions, higher prescription costs, more visits overall, higher visit costs, higher hospitalization costs, and higher total costs per member per month (PMPM) than non-hysterectomy patients. After surgery, the hysterectomy patients' costs and utilization PMPM are higher than those for the non-hysterectomy patients.

Conclusions: There is wide variation in the treatment of patients with DUB. Clinical practice improvement studies are needed to determine the appropriate treatments based on patient characteristics to achieve better outcomes for lower costs.