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Title: Increasing the adoption of ambulatory hysteroscopy in Australia-cost comparisons and patient satisfaction.
Epworth Authors: Nanayakkara, Pavitra
Aref-Adib, Mehrnoosh
Ades, Alex
Other Authors: Xiao, Joyce
Keywords: Ambulatory
Abnormal Uterine Bleeding
Endometrial Sampling
Patient Satisfaction
Economic Benefit
Women's and Children's Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Apr-2022
Publisher: Taylor and Francis
Citation: Obstet Gynaecol . 2022 Apr;42(3):509-513
Abstract: We present the findings of a prospective cohort study in a single tertiary hospital to review the patient experience and economic benefit of ambulatory hysteroscopy (AH). Data were collected between May 2017 and February 2020. Patient satisfaction was measured with qualitative survey. Hospital level financial data were obtained over two financial years (2017/18 and 2018/19) to identify seasonal variation. The primary outcome was patient satisfaction and the secondary outcome was cost of AH compared to hysteroscopy under GA. Three hundred and twenty-nine patients underwent AH. Two hundred and ninety-eight responses (91%) were collected. Ninety-five percent of procedures were successful. Median pain score was five out of 10. Despite pain, 94% of patients would undergo AH again and 97% would recommend it. The average hospital cost for AH was $259 compared with $3098 for hysteroscopy under GA. These findings support AH as a safe, well-tolerated and economically viable alternative to hysteroscopy under GA.Impact StatementWhat is already known on this subject? Hysteroscopy is traditionally performed in an operating theatre under general anaesthesia (GA). Technological advancements allow for the procedure to be performed in an outpatient setting. Despite advantages of ambulatory hysteroscopy (AH), GA hysteroscopy is still the predominant intervention in Australia.What the results of this study add? Patient satisfaction in AH was assessed. The median pain score was five out of 10. Despite pain, 94% of patients would undergo AH again and 97% would recommend it. What the implications are of these findings for clinical practice and/or further research? AH is a well-tolerated alternative to hysteroscopy under GA with significant cost benefits to the hospital and high patient satisfaction. Further research should focus on direct comparison of the two procedure approaches using randomised controlled trials.
DOI: 10.1080/01443615.2021.1916814
PubMed URL:
ISSN: 1479-828X
Journal Title: Journal of Obstetrics and Gynaecology
Type: Journal Article
Affiliated Organisations: Ambulatory Gynaecology Service, Royal Women's Hospital, Parkville, Australia.
Department of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.
Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia.
Type of Clinical Study or Trial: Prospective Cohort Study
Appears in Collections:Health Administration
Women's and Children's

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