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Uterine fibroid embolization underused in US

Uterine fibroid embolization costs substantially less and results in shorter hospital stays but is extremely underutilized in the U.S. compared with hysterectomies, according to a recent presentation at the Society for Interventional Radiology’s Annual Scientific Meeting.

Researchers found the discrepancy was especially great in rural and smaller hospitals.

"These findings suggest there is a lack of awareness about this safe, effective and less invasive therapy for uterine fibroids," Prasoon Mohan, MD, MRCS, assistant professor, interventional radiology department, University of Miami Leonard M. Miller School of Medicine, said in a press release. "Interventional radiologists urge health care professionals to present patients with all available treatment options so that the patient can make an informed decision. Patients need to know about the major differences between surgical treatments and [uterine fibroid embolization], especially that this is a nonsurgical treatment that preserves the uterus and has a much faster recovery time compared to hysterectomy."

Mohan and colleagues analyzed billing code data from the 2012 and 2013 Nationwide Inpatient Sample, a database that provides information on national estimates of hospital inpatient stays. ANOVA, t-test and chi squared test were used for statistical analysis.

They found that during the period studied, 167,650 hysterectomies and 2,470 uterine fibroid embolization took place. There were statistically significant differences between the uterine fibroid embolization and hysterectomy groups in total hospital charges ($21,583 vs. $33,104, P < .001), number of comorbidities (2.28 vs. 2.4, P < .005), mean hospital stay (2.16 days vs. 2.32 days, P < .005) and the mean age when the procedure was performed (44.8 years vs. 45.9 years, P < .005).

Further analysis showed that only 0.4% of uterine fibroid embolizations took place in rural hospitals, compared with 9.4% of hysterectomies (P < .01). In addition, 7.9% of uterine fibroid embolizations were performed at small hospitals, compared with 67.4% of these procedures being performed at large facilities.

"The fact that so few women undergo [uterine fibroid embolization] in rural and small hospital settings shows a health care access and education disparity in who receives this treatment. It is important that we continue to educate patients about choice and determine ways to increase access to this effective, less invasive therapy," Mohan said in the release.

Researchers also attributed the differences between the two procedures to the introduction of an ICD-9 code for uterine fibroid embolization in 2011.

References:

Narayanyan S, et al. Abstract 106. Presented at: Society of Interventional Radiology Annual Scientific Meeting; March 4-9, 2017; Washington, D.C.

Nationwide Inpatient Sample Overview (accessed 03-27-2017)

Disclosure: Healio Family Medicine was unable to confirm the researchers’ disclosures prior to publication.