Investigators at University of Michigan Describe Findings in Pelvic Organ Prolapse (Rate of Pelvic Organ Prolapse Surgery-Among Privately Insured…

Medical Letter on the CDC & FDA

Investigators at University of Michigan Describe Findings in Pelvic Organ Prolapse (Rate of Pelvic Organ Prolapse Surgery-Among Privately Insured Women in the United States, 2010-2013)

By a News Reporter-Staff News Editor at Medical Letter on the CDC & FDA -- A new study on Pelvic Organ Prolapse is now available. According to news reporting out of Ann Arbor, Michigan, by NewsRx editors, research stated, "To analyze utilization of, and payments for, pelvic organ prolapse procedures after the 2011 U.S. Food and Drug Administration (FDA) communication regarding transvaginal mesh."

Our news journalists obtained a quote from the research from the University of Michigan, "This is a retrospective cohort study examining private claims from three insurance providers for inpatient and outpatient prolapse procedures from 2010 to 2013 in the Health Care Cost Institute. Primary outcomes were the change in utilization of prolapse procedures, with and without mesh, before and after the July 2011 FDA communication. Secondary outcomes were the changes in payments and reimbursements for these procedures. Utilization rates and payments were compared using generalized linear models and interrupted time-series analysis. Utilization of prolapse procedures decreased from 12.3 to 9.7 per 10,000 woman-years (P=.027) with a decrease of 30.7% (3.9 in 2010 to 2.7 in 2013, P=.05) in number of mesh procedures and 16.6% (8.4 in 2010 to 7.0 in 2013, P=.011) for nonmesh procedures. Quarterly utilization of mesh procedures was increasing before the FDA communication and then significantly declined after its release (slope50.024 vs 20.025, P=.002). Nonmesh procedures, however, were already slightly decreasing before July 2011 and continued to decline at a more rapid pace after that time, although not significantly (slope520.004 vs 20.022, P=.47). Inpatient utilization decreased 52.2% (P=.002), whereas outpatient utilization increased 18.5% (P=.132). Payments for individual inpatient procedures, with and without mesh, increased by 12.0% ($8,315 in 2010 to $9,315 in 2013, P=.001) and 15.6% ($7,826 in 2010 to $9,048 in 2013, P=.005), respectively, whereas those for outpatient procedures increased by 41% ($4,961 in 2010 to $6,981 in 2013, P=.006) and 30% ($3,955 in 2010 to $5,149 in 2013, P=.004), respectively. Use of prolapse surgery declined during the study period. After the 2011 FDA communication regarding transvaginal mesh, there was a significant decrease in the utilization of procedures with mesh but not for those without mesh."

According to the news editors, the research concluded: "A shift toward outpatient surgeries was observed, and payments for both individual inpatient and outpatient cases increased."

For more information on this research see: Rate of Pelvic Organ Prolapse Surgery-Among Privately Insured Women in the United States, 2010-2013. Obstetrics and Gynecology, 2018;131(3):484-492. Obstetrics and Gynecology can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Obstetrics and Gynecology - journals.lww.com/greenjournal/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting A.G. Sammarco, University of Michigan, Inst Healthcare Policy & Innovat, Ann Arbor, MI 48109, United States. Additional authors for this research include C.W. Swenson, N.S. Kamdar, E.K. Kobernik, J.O.L. DeLancey, B. Nallamothu and D.M. Morgan (see also Pelvic Organ Prolapse).

Keywords for this news article include: Ann Arbor, Michigan, United States, North and Central America, Government Agencies Offices and Entities, Pelvic Organ Prolapse, Health and Medicine, Women's Health, Surgery, University of Michigan.