Abstract | OBJECTIVE: DESIGN: Analysis of Hospital Episodes Statistics (HES) data to produce rates of surgery for English Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs). POPULATION: METHODS: Multilevel Poisson regression was used to determine the level of systematic variation in the regional rates of surgery and their association with regional characteristics (deprivation, service provision and mix of surgical procedures). MAIN OUTCOME MEASURE: Age-standardised annual rates of surgery. RESULTS: The English rate of surgery for menorrhagia was 143 procedures per 100 000 women. Surgical rates within SHAs ranged from 52 to 230 procedures per 100 000 women, while rates within PCTs ranged from 20 to 420 procedures per 100 000 women. While, 60% of all procedures were endometrial ablations, the proportion across SHAs varied, ranging from 46% to 75%. Surgery rates were associated with the regional characteristics, but only weakly, and risk adjustment reduced the amount of unexplained variation by <15% at both SHA and PCT levels. CONCLUSION: Regional differences in surgical rates for menorrhagia have persisted despite changes in practice and improved evidence, suggesting there is scope for improving the management of menorrhagia within England.
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Authors | D A Cromwell, T A Mahmood, A Templeton, J H van der Meulen |
Journal | BJOG : an international journal of obstetrics and gynaecology
(BJOG)
Vol. 116
Issue 10
Pg. 1373-9
(Sep 2009)
ISSN: 1471-0528 [Electronic] England |
PMID | 19656147
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Endometrial Ablation Techniques
(statistics & numerical data)
- England
- Female
- Humans
- Hysterectomy
(statistics & numerical data)
- Menorrhagia
(surgery)
- Middle Aged
- Regression Analysis
- Residence Characteristics
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