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National trends in inpatient endometriosis admissions: Patients, procedures and outcomes, 2006−2015


Autoři: Stephanie J. Estes aff001;  Ahmed M. Soliman aff002;  Andrew J. Epstein aff003;  Julia C. Bond aff003;  Keith Gordon aff002;  Stacey A. Missmer aff004
Působiště autorů: Department of Obstetrics and Gynecology, Penn State Health, Hershey, PA, United States of America aff001;  AbbVie Inc., North Chicago, IL, United States of America aff002;  Medicus Economics, Philadelphia, PA, United States of America aff003;  Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, Michigan, United States of America aff004;  Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222889

Souhrn

Introduction

Despite guidance towards minimally invasive, outpatient procedures for endometriosis, many patients nonetheless receive inpatient care. Our objective was to assess trends in patient and hospital characteristics, surgical complications and hospital charges for women with an endometriosis-related inpatient admission in the United States.

Methods

We conducted a pooled cross-sectional analysis of Healthcare Cost and Utilization Project Nationwide Inpatient Sample data. Visits were stratified into three time-period-defined cohorts (2006–2007, 2010–2011, and 2014 through the first three quarters of 2015). Visits were included if the patient was aged 18–49 years and the primary diagnosis code was for endometriosis (International Classification of Diseases, 9th Revision code 617.xx). We evaluated counts of inpatient admissions and rates of patient and hospital characteristics.

Results

The number of inpatient admissions with a primary diagnosis code for endometriosis decreased by 72.8% from 2006 to 2015. At the same time, among those admitted for inpatient care for endometriosis, the proportions who had Medicaid insurance and multiple documented comorbidities increased. From 2006 to 2015, mean total hospital charges increased by 75% to $39,662 in 2015 US dollars, although average length of stay increased by <1 day.

Conclusions

The number of inpatient admissions with a primary diagnosis of endometriosis decreased over the past decade, while surgical complications and associated hospital charges increased. The share of patients with multiple comorbidities increased and an increasing proportion of inpatient endometriosis admissions were covered by Medicaid and occurred at urban teaching hospitals. These findings suggest a demographic shift in patients receiving inpatient care for endometriosis towards more complex, vulnerable patients.

Klíčová slova:

Medicine and health sciences – Health care – Health care facilities – Hospitals – Patients – Surgical and invasive medical procedures – Outpatients – Inpatients – Surgical excision – Minimally invasive surgery – Reproductive system procedures – Laparoscopy – Hysterectomy


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