Abstract
Medical management prior to hysterectomy for benign indications: Trends from a tertiary-care centre
Highlights
Hysterectomy is currently identified as a Quality-Based Procedure (QBP), meaning that funding for this procedure will become tied to evidence of improved quality of care and will have standardized care delivery across provinces for improved cost efficiency
We found that women presented at Morbidity and Mortality (M&M) were repeatedly identified as never having a trial of medical management prior to having a hysterectomy, not having minimally invasive surgical approach to hysterectomy and not having adequate pre-operative optimization of medical co-morbidities
Hysterectomies performed for 4 major benign indications –uterine fibroids, pelvic pain, abnormal uterine bleeding and pelvic organ prolapse - were included in the review
Summary
Hysterectomy is currently identified as a Quality-Based Procedure (QBP), meaning that funding for this procedure will become tied to evidence of improved quality of care and will have standardized care delivery across provinces for improved cost efficiency. We found that women presented at M&Ms were repeatedly identified as never having a trial of medical management prior to having a hysterectomy, not having minimally invasive surgical approach to hysterectomy and not having adequate pre-operative optimization of medical co-morbidities. This sparked an interest in understanding the overall practice trends in benign hysterectomy for all women at our centre. Coming at a time when provinces, including Ontario, are moving away from global hospital funding and towards funding based on specific procedures and patient outcomes, we initiated a chart review of practice trends in benign hysterectomy in our institution to identify gaps in quality care and prepare our institution for QBP
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