AHRQ Stats: Rates of Hysterectomy and Oophorectomy

Hysterectomies performed in ambulatory surgery or inpatient settings without oophorectomy (removal of ovaries) increased nearly 15 percent from 2005 to 2013. During the same period, however, the rate of hysterectomies performed in combination with oophorectomies decreased nearly 30 percent. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #214: Trends in Hysterectomies and Oophorectomies in Hospital Inpatient and Ambulatory Settings, 2005–2013.)

Highlights

In five States in 2013, there were 65,900 hospital visits in which a hysterectomy, an oophorectomy, or both surgeries were performed. Of these surgeries, 60.4 percent occurred in the outpatient setting.

The rate of hysterectomy surgeries (across inpatient and ambulatory surgery settings) decreased 12.3 percent from 2005 to 2013. The trend varied depending on whether an oophorectomy was performed at the same time: the rate increased 14.8 percent when hysterectomy was performed alone and decreased 29.4 percent when the hysterectomy and oophorectomy were combined.

The rate of oophorectomy alone decreased 11.9 percent from 2005 to 2013.

In five States in 2013, 26,400 hysterectomy and oophorectomy surgeries were performed during the same hospital-based visit. These surgeries performed in combination were done slightly more often in the inpatient setting (53 percent) than in the outpatient setting (47 percent).

In five States, benign neoplasms and other gynecological and maternal conditions were the most common conditions related to hysterectomy and oophorectomy surgeries in 2013.

Regardless of the condition related to the surgery, women aged 55 years and older were more likely to have oophorectomy and hysterectomy surgeries performed in combination.

November 2016

Trends in Hysterectomies and Oophorectomies in Hospital Inpatient and Ambulatory Settings, 2005-2013

Brian J. Moore, Ph.D., Claudia A. Steiner, M.D., M.P.H., P. Hannah Davis, M.S., Carol Stocks, Ph.D., R.N., and Marguerite L. Barrett, M.S.

Introduction

Hysterectomy—removal of the uterus—is the second most common surgical procedure among women in the United States, with more than 265,000 hysterectomies performed annually in the inpatient setting.¹ Recent research has shown a decrease in the overall rate of hysterectomies and a large increase in the proportion of hysterectomies performed in an outpatient setting.^2,3 However, these studies were restricted to either commercially insured women without cancer or women receiving treatment for benign uterine fibroids.

Oophorectomy is a surgical procedure that removes one or both ovaries. Nearly 200,000 oophorectomies are performed annually in the inpatient setting among women in the United States.⁴ Elective oophorectomy is routinely offered to older women at the time of hysterectomy to prevent the development of ovarian cancer.⁵ Similar patterns of decreasing overall rates of oophorectomy with increasing proportions performed in an outpatient setting have been identified among commercially insured women.⁶

This Healthcare Cost and Utilization Project (HCUP) Statistical Brief presents data on hysterectomies and oophorectomies among adult women using all-payer data in two hospital settings: hospital inpatient and hospital-based ambulatory surgery. The analysis is limited to adult women undergoing a hysterectomy, an oophorectomy, or both in combination in five States (Connecticut, Indiana, Kansas, Ohio, and South Carolina) for which hysterectomies and oophorectomies could be identified in both the inpatient and ambulatory surgery settings using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes.⁷ These five States represented 9.3 percent of the total U.S. population in 2013.

In this Statistical Brief we provide an overview of patient and hospital characteristics for hysterectomies alone, oophorectomies alone, and surgeries when both procedures were performed during the same hospital-based visit—hysterectomy and oophorectomy surgeries "in combination." Trends from 2005 through 2013 in the rates of hysterectomies and oophorectomies, overall and by hospital setting (inpatient and ambulatory surgery), are presented. The distribution in 2013 of surgeries performed by related condition and by age is also provided.

Findings

Distribution of hospital-based hysterectomies and oophorectomies, 2013
Figure 1 presents the number of hospital-based visits for hysterectomy, oophorectomy, or both in combination, and the distribution by hospital setting—inpatient or ambulatory surgery—in five States in 2013.