Abstract
ObjectivesThe impact of benign gynecological conditions on life of women and on costs for the society is high. The purpose of this study is to gain knowledge and understanding of costs of the treatment of these disorders in order to be able to improve the clinical care processes, gain insight into feasible savings opportunities and to allocate funds wisely.MethodsThe healthcare processes of 311 women attending university or community hospitals in the Helsinki and Uusimaa Hospital District between June 2012 and August 2013 due to a benign gynecological condition were followed up for two years and treatment costs analysed.ResultsTotal direct hospital costs averaged 689€ at six months and 2194€ at two years. The most expensive treatment was that of uterine fibroids in the short term and that of endometriosis and fibroids later on. Costs did not depend on hospital size. Surgical operations caused nearly half of hospital costs. Productivity loss caused biggest expenses outside of the hospital. LNG-IUD (levonorgestrel-releasing intrauterine device) accounted for the largest pharmaceutical costs for patients. Hospital treatment was associated with a reduced need for outpatient services during follow-up.ConclusionsA majority of direct hospital costs arise over time. This stresses the need for prolonged healthcare management. To control costs, the need for repetitive doctors’ appointments, monitoring tests, and ward treatments should be carefully evaluated. Procedures not needing an operation theatre (for example hysteroscopy for polypectomy), should be done ambulatorily.
Highlights
The impact of common benign gynecological conditions on the life of women [1] and on the costs for the society is high [2,3,4,5,6]
The most expensive treatment was that of uterine fibroids in the short term and that of endometriosis and fibroids later on
A majority of direct hospital costs arise over time
Summary
The impact of common benign gynecological conditions on the life of women [1] and on the costs for the society is high [2,3,4,5,6]. Half of women suffer from a benign gynecological condition during their fertile life [7]. Costs of benign gynecological conditions are high and similar to those of chronic diseases such as diabetes, Crohn’s disease, Parkinson’s disease, and rheumatoid arthritis [10, 11]. Gynecological bleeding disorders, for example, account for annual costs of $13 billion [8] and endometriosis for $22 billion (0.7% of US annual health care expenditure) in the US [12, 13]
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