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Variations in vaginal and abdominal hysterectomy by region and trust in England
Author(s) -
Bottle Alex,
Aylin Paul
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2005.00291.x
Subject(s) - medicine , logistic regression , abdominal hysterectomy , obstetrics , hysterectomy , health services , variation (astronomy) , population , demography , regional variation , general surgery , gynecology , surgery , environmental health , physics , sociology , astrophysics , political science , law
Objective To examine variations between regions and hospitals in the proportion of hysterectomies performed abdominally. Design Analysis of routine hospital data. Setting All National Health Service hospitals in England. Population Women aged 18+ hospitalised between April 1998 and March 2001. Methods Logistic regression, adjusting for age and diagnosis. Main outcome measure Use of the abdominal rather than the vaginal route. Results The adjusted proportion of hysterectomies performed abdominally varied from 75–89% between regions, and from 25–99% between hospitals. Diagnosis accounted for nearly a third of the total variation, dwarfing the contributions of age and hospital. About two‐thirds of the variation remained unaccounted for. Conclusion Despite evidence suggesting that the majority of hysterectomies may be performed vaginally, very few English trust match this.