Association of Demographic, Clinical, and Hospital-Related Factors With Use of Robotic Hysterectomy for Benign Indications: A National Database Study

Abstract [from journal]

Background: We examined the association of patient factors, gynecologic diagnoses, and hospital characteristics with utilization of the robotic approach for benign hysterectomy.

Methods: We performed cross‐sectional study of women (n = 725 050) undergoing hysterectomies in the 2012 to 2014 National Inpatient Sample.

Results: A total of 725 050 women underwent inpatient hysterectomy for benign indications: 70345 (10%) were performed robotically. Women were more likely to receive robotic hysterectomy at teaching hospitals (RR 1.60 [95% CI 1.54‐1.66]) after adjustment for other patient factors, gynecologic diagnoses, and hospital characteristics. They were more likely to undergo robotic hysterectomy at large (RR 1.34 [95% CI 1.29‐1.39]) and for‐profit hospitals (RR 1.16 [95% CI 1.11‐1.22]). Women were less likely to undergo robotic hysterectomy if they were rural (RR 0.68 [95% CI 0.64‐0.72]), African‐American (RR 0.78 [95% CI 0.74‐0.82]), or publicly insured or uninsured (RR 0.55 [95% CI 0.53‐0.57]) women.

Conclusion: Significant geographic and hospital‐level disparities exist in access to robotic hysterectomy in the United States.