Costs and mortality rates of surgical approaches to hysterectomy in Brazil

Rev Saude Publica. 2018 Mar 12:52:25. doi: 10.11606/S1518-8787.2018052000129.

Abstract

Objective: To analyze the costs of hysterectomies performed in Brazil due to benign conditions, and to assess its hospital admittance and mortality rates.

Methods: A retrospective cohort was carried out from January 2010 to December 2014, analyzing all hysterectomies (n = 428,346) registered on the DATASUS database between January 2010 and December 2014. Data were collected through a structured questionnaire and analyzed using the SPSS 20.0 for Windows.

Results: Hospital admissions were 300,231 for total abdominal hysterectomies, 46,056 for vaginal hysterectomies, 29,959 for subtotal abdominal hysterectomies and 1,522 for laparoscopic hysterectomies. Mortality rates were 0.26%, 0.09%, 0.07% and 0.05% for subtotal, total abdominal, laparoscopic, and vaginal hysterectomies, respectively. Among the procedures studied, total abdominal hysterectomies had the most costs (R$217,802,574.77), followed by vaginal hysterectomies (R$24,173,490.00), subtotal abdominal hysterectomies (R$19.253.300,00) and laparoscopic hysterectomies (R$794,680.40).

Conclusions: Total abdominal hysterectomies had the highest overall costs mainly because it was the most commonly performed technique. Mortality rates were greatest in subtotal abdominal hysterectomies; this, however, may be due to bias related to missing data in our database.

MeSH terms

  • Brazil / epidemiology
  • Databases, Factual
  • Female
  • Humans
  • Hysterectomy / economics*
  • Hysterectomy / methods
  • Hysterectomy / mortality*
  • Hysterectomy, Vaginal / economics
  • Hysterectomy, Vaginal / mortality
  • Laparoscopy / methods
  • Mortality
  • Patient Admission / statistics & numerical data
  • Retrospective Studies