Cost-Analysis Comparison of Outpatient See-and-Treat Hysteroscopy Service with Other Hysteroscopy Service Models

Study Objective: To conduct a cost analysis of 3 different hysteroscopy service models. Design: Decision-analytic model constructed from the UK National Health Service perspective (Canadian Task Force classification III). Setting: Tertiary-care hospital. Patients: Women undergoing hysteroscopy (N = 1109). Interventions: Three hysteroscopy service models: outpatient see-and-treat service; outpatient diagnostic hysteroscopy followed by referral for operative hysteroscopy under general anesthesia (outpatient and referral service); and general anesthesia see-and-treat service. Measurements and Main Results: Costs were measured in 2008 UK pounds sterling. Of the 3 treatment arms, total costs were lowest with outpatient see-and-treat service. The lower cost of the outpatient see-and-treat service was observed across a number of patient subgroups (age, menopause status, and indication) and when subjected to sensitivity analyses. Conclusions: Outpatient see-and-treat hysteroscopy was associated with the lowest treatment costs. This service model may reduce the total cost of care in women referred for hysteroscopy. Journal of Minimally Invasive Gynecology (2010) 17, 518 525 (c) 2010 AAGL. All rights reserved.