Table 2.
Patient and Hospital Characteristics by Mode of Hysterectomy
| All Hysterectomies |
Benign Hysterectomies |
|||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| All (n = 479 814) | Abdominal (n = 278 055) | Laparoscopic (n = 90 906) | Vaginal (n = 81 665) | Robotic (n = 26 990) | All (n = 415 404) | Abdominal (n = 232 633) | Laparoscopic (n = 84 569) | Vaginal (n = 77 940) | Robotic (n = 18 836) | |||||||||||
| Age [mean (SE)] (y) | 48.0 | (0.2) | 47.8 | (0.2) | 45.4 | (0.2) | 50.6 | (0.3) | 50.7 | (0.6) | 46.5 | (0.1) | 45.7 | (0.1) | 44.6 | (0.2) | 50.8 | (0.3) | 47.1 | (0.4) |
| Race/ethnicity [n (%)] | ||||||||||||||||||||
| White | 277 315 | (57.8) | 148 855 | (53.5) | 58 535 | (64.4) | 52 098 | (63.8) | 16 429 | (60.9) | 237 870 | (57.3) | 121 790 | (52.4) | 53 892 | (63.7) | 49 741 | (63.8) | 11 630 | (61.7) |
| Black | 62 657 | (13.1) | 47 791 | (17.2) | 7731 | (8.5) | 4828 | (5.9) | 2088 | (7.7) | 57 810 | (13.9) | 43 829 | (18.8) | 7460 | (8.8) | 4658 | (6.0) | 1705 | (9.1) |
| Hispanic | 44 801 | (9.3) | 27 248 | (9.8) | 7223 | (7.9) | 8277 | (10.1) | 1948 | (7.2) | 39 501 | (9.5) | 23 478 | (10.1) | 6717 | (7.9) | 7747 | (9.9) | 1474 | (7.8) |
| Asian/Pacific Islander | 10 638 | (2.2) | 7053 | (2.5) | 1580 | (1.7) | 1348 | (1.7) | 611 | (2.3) | 8802 | (2.1) | 5649 | (2.4) | 1402 | (1.7) | 1305 | (1.7) | 410 | (2.2) |
| Native American | 3744 | (0.8) | 1647 | (0.6) | 750 | (0.8) | 948 | (1.2) | 394 | (1.5) | 3132 | (0.8) | 1320 | (0.6) | 718 | (0.8) | 920 | (1.2) | 169 | (0.9) |
| Other | 12 798 | (2.7) | 8199 | (2.9) | 1760 | (1.9) | 2099 | (2.6) | 666 | (2.5) | 10 883 | (2.6) | 6779 | (2.9) | 1591 | (1.9) | 2003 | (2.6) | 466 | (2.5) |
| Missing | 67 860 | (14.1) | 37 262 | (13.4) | 13 327 | (14.7) | 12 067 | (14.8) | 4854 | (18.0) | 57 405 | (13.8) | 29 788 | (12.8) | 12 791 | (15.1) | 11 567 | (14.8) | 2982 | (15.8) |
| Indicationa [n (%)] | ||||||||||||||||||||
| Fibroids | 223 492 | (46.6) | 148 811 | (53.5) | 41 469 | (45.6) | 22 626 | (27.7) | 10 338 | (38.3) | 214 689 | (51.7) | 142 501 | (61.3) | 40 518 | (47.9) | 22 133 | (28.4) | 9325 | (49.5) |
| Endometriosis | 100 831 | (21.0) | 61 981 | (22.3) | 24 024 | (26.4) | 10 339 | (12.7) | 4385 | (16.2) | 97 044 | (23.4) | 59 311 | (25.5) | 23 579 | (27.9) | 10 038 | (12.9) | 4033 | (21.4) |
| Prolapse | 79 464 | (16.6) | 13 449 | (4.8) | 14 332 | (15.8) | 49 263 | (60.3) | 2383 | (8.8) | 77 535 | (18.7) | 12 812 | (5.5) | 13 930 | (16.5) | 48 492 | (62.2) | 2264 | (12.0) |
| Gynecologic cancer | 64 410 | (13.4) | 45 422 | (16.3) | 6337 | (7.0) | 3724 | (4.6) | 8154 | (30.2) | ||||||||||
| Menstrual disorder | 216 080 | (45.0) | 122 936 | (44.2) | 51 203 | (56.3) | 32 228 | (39.5) | 9537 | (35.3) | 212 615 | (51.2) | 120 861 | (52.0) | 50 583 | (59.8) | 31 686 | (40.7) | 9310 | (49.4) |
| Other | 42 514 | (8.9) | 29 101 | (10.5) | 6812 | (7.5) | 2434 | (3.0) | 3107 | (11.5) | 42 514 | (10.2) | 29 101 | (12.5) | 6812 | (8.1) | 2434 | (3.1) | 3107 | (16.5) |
| Adnexal surgery [n (%)] | 274 639 | (57.2) | 188 609 | (67.8) | 48 605 | (53.5) | 19 010 | (23.3) | 17 926 | (66.4) | 219 608 | (52.9) | 147 086 | (63.2) | 43 554 | (51.5) | 18 033 | (23.1) | 10 614 | (56.3) |
| Urban–rural location [n (%)] | ||||||||||||||||||||
| “Central” ≥1 million | 125 683 | (26.5) | 75 365 | (27.4) | 21 753 | (24.3) | 18 520 | (23.0) | 9343 | (34.7) | 106 815 | (26.0) | 62 194 | (27.0) | 20 135 | (24.2) | 17 576 | (22.9) | 6405 | (34.2) |
| “Fringe” ≥1 million | 121 907 | (25.7) | 71 752 | (26.1) | 23 897 | (26.7) | 18 732 | (23.3) | 6993 | (26.0) | 104 660 | (25.5) | 59 549 | (25.9) | 21 962 | (26.4) | 17 871 | (23.3) | 4932 | (26.3) |
| Metropolitan areas of 250 000–999 999 population | 84 012 | (17.7) | 46 710 | (17.0) | 15 569 | (17.4) | 15 907 | (19.8) | 5459 | (20.3) | 73 107 | (17.8) | 39 174 | (17.0) | 14 525 | (17.5) | 15 343 | (20.0) | 3840 | (20.5) |
| Metropolitan areas of 50 000–249 999 population | 48 053 | (10.1) | 25 115 | (9.1) | 10 714 | (12.0) | 9769 | (12.2) | 2273 | (8.5) | 43 025 | (10.5) | 21 567 | (9.4) | 10 138 | (12.2) | 9370 | (12.2) | 1850 | (9.9) |
| Micropolitan counties | 59 041 | (12.5) | 34 999 | (12.7) | 11 171 | (12.5) | 10 825 | (13.5) | 1772 | (6.6) | 51 884 | (12.7) | 29 894 | (13.0) | 10 549 | (12.7) | 10 208 | (13.3) | 1080 | (5.8) |
| Not metropolitan or micropolitan counties | 35 137 | (7.4) | 21 056 | (7.7) | 6291 | (7.0) | 6623 | (8.2) | 1059 | (3.9) | 30 572 | (7.5) | 17 655 | (7.7) | 5874 | (7.1) | 6331 | (8.3) | 637 | (3.4) |
| Median household income national quartile for patient ZIP code [n (%)] | ||||||||||||||||||||
| $1–$38 999 | 116 974 | (24.9) | 73 903 | (27.2) | 19 430 | (21.9) | 18 253 | (22.8) | 4895 | (18.4) | 102 320 | (25.2) | 63 225 | (27.8) | 18 146 | (21.9) | 17 218 | (22.6) | 3385 | (18.3) |
| $39 000–$47 999 | 122 021 | (26.0) | 71 462 | (26.3) | 21 838 | (24.6) | 22 140 | (27.7) | 6018 | (22.6) | 106 474 | (26.2) | 60 414 | (26.6) | 20 493 | (24.8) | 21 136 | (27.7) | 4090 | (22.1) |
| $48 000–$62 999 | 116 437 | (24.8) | 63 775 | (23.5) | 23 572 | (26.5) | 21 274 | (26.6) | 7282 | (27.4) | 101 425 | (25.0) | 53 317 | (23.5) | 22 085 | (26.7) | 20 410 | (26.8) | 5237 | (28.3) |
| ≥$63 000 | 113 704 | (24.2) | 62 404 | (23.0) | 24 043 | (27.1) | 18 291 | (22.9) | 8379 | (31.5) | 95 975 | (23.6) | 50 313 | (22.1) | 21 983 | (26.6) | 17 530 | (23.0) | 5797 | (31.3) |
| Primary payer [n (%)] | ||||||||||||||||||||
| Medicare | 61 863 | (12.9) | 33 610 | (12.1) | 7270 | (8.0) | 15 596 | (19.1) | 4618 | (17.1) | 41 303 | (10.0) | 18 386 | (7.9) | 5452 | (6.5) | 15 022 | (19.3) | 1899 | (10.1) |
| Medicaid | 50 774 | (10.6) | 32 299 | (11.6) | 8337 | (9.2) | 8119 | (10.0) | 1753 | (6.5) | 44 590 | (10.8) | 28 066 | (12.1) | 7749 | (9.2) | 7346 | (9.4) | 1273 | (6.8) |
| Private including HMOc | 329 717 | (68.9) | 187 855 | (67.7) | 69 043 | (76.2) | 52 422 | (64.3) | 19 388 | (71.9) | 296 699 | (71.6) | 165 233 | (71.2) | 65 566 | (77.8) | 50 469 | (64.9) | 14 782 | (78.5) |
| Self-pay | 16 743 | (3.5) | 11 916 | (4.3) | 2347 | (2.6) | 2032 | (2.5) | 393 | (1.5) | 14 339 | (3.5) | 10 127 | (4.4) | 2115 | (2.5) | 1826 | (2.3) | 240 | (1.3) |
| No charge | 1891 | (0.4) | 1200 | (0.4) | 388 | (0.4) | 252 | (0.3) | 46 | (0.2) | 1 642 | (0.4) | 1020 | (0.4) | 358 | (0.4) | 228 | (0.3) | 30 | (0.2) |
| Other | 17 662 | (3.7) | 10 474 | (3.8) | 3265 | (3.6) | 3063 | (3.8) | 773 | (2.9) | 15 793 | (3.8) | 9203 | (4.0) | 3082 | (3.7) | 2873 | (3.7) | 602 | (3.2) |
| Region of hospital [n (%)] | ||||||||||||||||||||
| Northeast | 74 787 | (15.6) | 42 755 | (15.4) | 15 497 | (17.0) | 11 552 | (14.1) | 4499 | (16.7) | 63 471 | (15.3) | 35 217 | (15.1) | 13 814 | (16.3) | 11 042 | (14.2) | 3079 | (16.3) |
| Midwest | 112 415 | (23.4) | 63 719 | (22.9) | 18 559 | (20.4) | 21 997 | (26.9) | 7476 | (27.7) | 95 012 | (22.9) | 50 965 | (21.9) | 17 438 | (20.6) | 21 104 | (27.1) | 5045 | (26.8) |
| South | 193 769 | (40.4) | 122 029 | (43.9) | 34 951 | (38.4) | 27 740 | (34.0) | 8461 | (31.3) | 172 334 | (41.5) | 106 308 | (45.7) | 32 972 | (39.0) | 26 365 | (33.8) | 6309 | (33.5) |
| West | 98 843 | (20.6) | 49 552 | (17.8) | 21 899 | (24.1) | 20 376 | (25.0) | 6554 | (24.3) | 84 586 | (20.4) | 40 144 | (17.3) | 20 344 | (24.1) | 19 430 | (24.9) | 4403 | (23.4) |
| % of all operations performed on outpatient basis [mean (SE)] | 59.4 | (0.7) | 59.5 | (0.7) | 60.1 | (0.9) | 59.8 | (0.9) | 54.4 | (1.4) | 59.8 | (0.7) | 60.0 | (0.7) | 60.4 | (0.9) | 59.9 | (0.9) | 54.5 | (1.6) |
| Location and teaching status [n (%)] | ||||||||||||||||||||
| Rural | 56 926 | (12.1) | 33 169 | (12.2) | 11 189 | (12.5) | 11 994 | (15.0) | 487 | (1.9) | 53 371 | (13.1) | 30 754 | (13.5) | 10 829 | (13.0) | 11 349 | (14.9) | 357 | (2.0) |
| Urban non-teaching | 202 908 | (43.2) | 115 964 | (42.6) | 39 815 | (44.6) | 36 963 | (46.2) | 9642 | (36.8) | 184 822 | (45.5) | 103 389 | (45.5) | 38 018 | (45.7) | 35 600 | (46.6) | 7441 | (40.7) |
| Urban teaching | 209 812 | (44.7) | 122 771 | (45.2) | 38 338 | (42.9) | 31 044 | (38.8) | 16 103 | (61.4) | 168 344 | (41.4) | 93 221 | (41.0) | 34 263 | (41.2) | 29 411 | (38.5) | 10 492 | (57.4) |
| Hospital bed size [n (%)] | ||||||||||||||||||||
| Small | 51 419 | (10.9) | 27 913 | (10.3) | 13 042 | (14.6) | 8315 | (10.4) | 1880 | (7.2) | 45 048 | (11.1) | 23 607 | (10.4) | 12 356 | (14.9) | 8011 | (10.5) | 878 | (4.8) |
| Medium | 119 172 | (25.4) | 69 976 | (25.7) | 23 488 | (26.3) | 20 327 | (25.4) | 5072 | (19.3) | 106 582 | (26.2) | 60 556 | (26.6) | 22 482 | (27.1) | 19 524 | (25.6) | 3812 | (20.8) |
| Large | 299 055 | (63.7) | 174 015 | (64.0) | 52 813 | (59.1) | 51 359 | (64.2) | 19 280 | (73.5) | 254 907 | (62.7) | 143 202 | (63.0) | 48 272 | (58.1) | 48 825 | (63.9) | 13 601 | (74.4) |
| Severity of illness subclass [n (%)] | ||||||||||||||||||||
| Minor loss of function | 323 017 | (67.3) | 174 860 | (62.9) | 69 196 | (76.1) | 60 535 | (74.1) | 18 088 | (67.0) | 296 068 | (71.3) | 159 007 | (68.4) | 65 312 | (77.2) | 57 911 | (74.3) | 13 572 | (72.1) |
| Moderate loss of function | 131 882 | (27.5) | 83 828 | (30.1) | 20 089 | (22.1) | 19 803 | (24.2) | 7875 | (29.2) | 105 354 | (25.4) | 63 633 | (27.4) | 17 981 | (21.3) | 18 833 | (24.2) | 4726 | (25.1) |
| Major loss of function | 20 565 | (4.3) | 15 968 | (5.7) | 1423 | (1.6) | 1185 | (1.5) | 914 | (3.4) | 11 727 | (2.8) | 8253 | (3.5) | 1128 | (1.3) | 1069 | (1.4) | 479 | (2.5) |
| Extreme loss of function | 4351 | (0.9) | 3400 | (1.2) | 198 | (0.2) | 141 | (0.2) | 114 | (0.4) | 2255 | (0.5) | 1741 | (0.7) | 148 | (0.2) | 127 | (0.2) | 59 | (0.3) |
| AHRQc comorbidity measure for obesity [n (%)] | 55 739 | (11.6) | 37 633 | (13.5) | 8134 | (8.9) | 5813 | (7.1) | 3981 | (14.7) | 43 074 | (10.4) | 28 179 | (12.1) | 7158 | (8.5) | 5414 | (6.9) | 2214 | (11.8) |
a
categories not mutually exclusive
c
AHRQ = Agency for Healthcare Research and Quality; HMO = Health Maintenance Organization.