Aims: The aim of the study was to estimate the annual hospital costs to New Zealand society of hysterectomy for nonmalignant conditions in women between puberty and menopause, and to compare international rates for all hysterectomies.
Methods: The records of patients aged between 15 and 54 years inclusive, who had a hysterectomy for a nonmalignant menstrual condition, were researched. Hospital costs were estimated using specific hospital unit costs and prices.
Results: The 4390 hysterectomies for nonmalignant conditions represent 69% of the total hysterectomies undertaken in New Zealand in 1991. Estimated costs for all hospitals were $17 million or $3868 per hysterectomy. The all ages all conditions hysterectomy rate per 100,000 women of 365 (368 in 1992) in New Zealand is higher than in some other developed countries.
Conclusions: Further reduction in the rate of hysterectomy in New Zealand may save hospital costs but these savings should be offset against the costs of any other treatment options chosen. Although it was found that unit costs of public hospitals were higher than those of private hospitals the case mix for the two types of hospital may differ and public hospital cost reductions may not be possible. Economic evaluation of alternative treatment options would be improved if all relevant costs (direct, indirect and intangible) were known. Further research is needed to determine the reasons why New Zealand women elect to have hysterectomies, why most choose a private hospital, and changes (before and after hysterectomy) in productivity, out of pocket expenses, and quality of life for these patients.