Menstrual disorders in women. Social economic consequences of examining women with menstrual disorders for cancer of the body of the uterus.

Abstract

To explore the health economic consequences of menstrual disorders in Denmark. Analysis of the total costs of menstrual disorders in women, and a cost effectiveness analysis of menstrual disorders in women. The analysis is based on retrospective 1991 data from the Danish National Patient Register, and from 1991 national production figures from the Danish National Health Insurance responsible for the primary health care sector. Furthermore, a survey of the incidence of cancer in Denmark in 1988 has been used. In the cost analysis all women who experienced menstrual disorders in 1991 are included, and in the cost effectiveness analysis all women with menstrual disorders who were examined by dilatation and curettage in 1991 were included. In the cost analysis the outcome measure is the total cost of treating and examining women with menstrual disorders in 1991. In the cost effectiveness analysis the outcome measure is the cost of diagnosing one new case of cancer of the body of the uterus in 1991. Menstrual disorders caused a resource use in the health care sector of 150 mill. DKK in 1991, i.e. approximately 0.4% of the total Danish health expenditure, of which at least 33 mill. DKK were spent on the ca. 25,000 dilatations and curettages which were performed in hospitals and the primary sector. Approximately 600 new cases of cancer of the body of the uterus were diagnosed in Denmark in 1991. The cost of finding one woman with cancer of the body of the uterus was on average 54,500 DKK. The cost variation per new case of cancer of the body of the uterus among different age groups was relatively large. The cost was 1.3 mill DKK per new case if the women were less than 40 years because of a low risk of having cancer of the body of the uterus in this age group. The cost per case was 21,500 DKK in women over 50 years. This article raised the question whether too many women under 40 years are examined today by dilatation and curettage when the cost effectiveness of examining the woman is considered.