1. The shift from inpatient to outpatient hysterectomy for endometrial cancer in the United States: trends, enabling factors, cost, and safety
- Author
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Kristina A. Butler, Andrea Mariani, Gretchen E. Glaser, Giovanni Scambia, Emeline Liu, Jvan Casarin, Carrie L. Langstraat, Javier F. Magrina, Yanli Li, Chao Song, Serena Cappuccio, Paul M. Magtibay, and Tommaso Grassi
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Enabling Factors ,Comorbidity ,Hysterectomy ,Logistic regression ,Robotic Surgical Procedures ,Surgical oncology ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Aged ,Retrospective Studies ,Surgical approach ,business.industry ,General surgery ,Endometrial cancer ,Obstetrics and Gynecology ,Retrospective cohort study ,Perioperative ,Middle Aged ,medicine.disease ,Endometrial Neoplasms ,Ambulatory Surgical Procedures ,Oncology ,Female ,business - Abstract
ObjectiveTo evaluate trends in outpatient versus inpatient hysterectomy for endometrial cancer and assess enabling factors, cost and safety.MethodsIn this retrospective cohort study, patients aged 18 years or older who underwent hysterectomy for endometrial cancer between January 2008 and September 2015 were identified in the Premier Healthcare Database. The surgical approach for hysterectomy was classified as open/abdominal, vaginal, laparoscopic or robotic assisted. We described trends in surgical setting, perioperative costs and safety. The impact of patient, provider and hospital characteristics on outpatient migration was assessed using multivariate logistic regression.ResultsWe identified 41 246 patients who met inclusion criteria. During the time period studied, we observed a 41.3% shift from inpatient to outpatient hysterectomy (pConclusionsA significant shift from inpatient to outpatient setting was observed for hysterectomies performed for endometrial cancer over time. Minimally invasive surgery, particularly the robotic approach, facilitated this migration, preserving clinical outcomes and leading to reduction in costs.
- Published
- 2021
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