Length of Hospital Stay and Costs Associated With Laparoscopic Versus Vaginal Hysterectomy: Study of 1,553 Patients [4L

Abstract

INTRODUCTION: The aim of this study was to assess whether there was a difference in length of hospital stay (LOS) and total hospital costs associated with Total Laparoscopic Hysterectomy (TLH) versus Total Vaginal Hysterectomy (TVH) for benign indications. METHODS: Medical records of 1,553 adult women undergoing elective TLH or TVH at a major academic institution from 2010 to 2015 were reviewed. CPT codes used for TLH included [58570-58573] and for TVH included [58260-58263, 58270, 58290-58294]. Patient demographics, LOS and total hospital cost associated with hospitalization for hysterectomy were collected. RESULTS: Of the 1,553 patients, 988 (63.6%) underwent TLH and 565 (36.4%) underwent TVH (TLH: n=988 vs. TVH: n=565). There was significant differences in Age, with TVH cohort being older (TLH: 44.9±10.3 years vs. TVH: 53.1±13.1 years, P<.0001). The majority of patients were White, with greater proportion in TVH cohort (TLH: 77.9% vs. TVH: 86.0%, P<.0001). There were significant differences in insurance status, with TLH cohort having greater proportion of patients with Commercial/Private (31.7% vs. 23.4%, P=.0005), BlueCross/BlueShield (34.1% vs. 32.2%, P=0.446), Medicaid (14.8% vs. 11.0%, P=.034), and lesser proportion with Medicare (11.0% vs. 26.0%, P<.0001). LOS was significantly greater for TVH cohort (TLH: 1.15±0.89 days vs. TVH: 1.47±0.87 days, P<0.0001). However, TLH cohort had significantly greater mean hospital costs of approximately $10,000 compared to TVH cohort (TLH: $40,518±16,243 vs. TVH: $30,295±12,201, P<.0001). CONCLUSION: Our study suggests that there are significant differences in LOS and total hospital costs associated with TVH and TLH, respectively. Further studies are necessary to optimize surgical decision making for hysterectomy.