Hospital-associated Costs of Chronic Pelvic Pain in Canada: A Population-based Descriptive Study.

Abstract

To determine the hospital-related costs incurred by women requiring surgery or inpatient admission for chronic pelvic pain in Canada. We conducted a population-based, cross-sectional study, focusing on women ages 15-59 with a most responsible International Classification of Diseases diagnosis of pelvic and perineal pain, dysmenorrhea, or dyspareunia who had surgery or inpatient admission with a discharge date between April 1, 2008 and March 31, 2012. This study was based on the Canadian Institute for Health Information Discharge Abstract database and the National Ambulatory Care Reporting System. Clinical diagnoses and interventions and resource intensity weights (RIW) were extracted. Hospital costs were estimated by multiplying cost per weighted case (CPWC) calculated at the national level with respective RIWs. Over four years, there were 34 346 cases of surgery or inpatient admission for chronic pelvic pain amounting to $100.5 million with an average cost of $25 million per year. Pelvic and perineal pain accounted for 61.5% (n= 21 127) of the cases, while dysmenorrhea accounted for 31.8% (n= 10 936), and dyspareunia accounted for 6.6% (n= 2283). The vast majority of the cases (92.9%, n= 31 923) were associated with surgical interventions, with the most common surgeries being hysterectomy (47.1%, n=16 189), followed by laparoscopy (25.8%, n= 8850), adnexal surgery (6.8%, n= 2349), and other procedures (11.6%, n= 3968). While these estimates do not take into account non-hospital related costs, such as outpatient treatment, loss of productivity, and impact on quality of life, this study demonstrates that chronic pelvic pain represents a considerable economic burden to Canada's health care system.