Large variations in the rates of hysterectomies across Australia has raised concerns many women are missing out on less invasive and highly effective treatments for painful female conditions.
A landmark report released on Wednesday 6 June 2017 by the Australian Commission on Safety and Quality in Healthcare shows that hysterectomy rates vary greatly from state to state, with surgeons in Victoria the most likely to prescribe the surgical procedure.
In fact, The Second Australian Atlas of Healthcare Variation found the highest rate of hysterectomy in Maryborough, Victoria was nearly seven times higher – 763 per 100,000 – than the lowest rate in Gunghalin, ACT at 115 per 100,000.
Professor Anne Duggan, a senior medical advisor for the commission, says the large variation is surprising and a conversation must be had about appropriate care.
“It’s a really interesting question of what’s going on in those sorts of places,” Duggan said.
Hysterectomy is the surgical removal of a woman’s uterus, or womb, and is commonly performed to treat uterine fibroids that cause pain, heavy bleeding and prolapse of the uterus.
It is generally becoming less common in developed countries, following the introduction of less invasive yet still highly effective treatment options such as endometrial ablation. However, hysterectomy in Australia remains more common than in many other comparable countries.
According to the Atlas, which examined more than 300 local areas nationally, the variation for endometrial ablation was even higher than hysterectomy.
The endometrial ablation rate was nearly 21 times higher in Burnie, Tasmania at 390 per 100,000 compared to the lowest rate in Fairfield, NSW at 19 per 100,000.
Again, this suggests that not all women are aware of the available treatment options, says Duggan
“You always expect to find some variation, and in many cases this is a good thing, as it shows the health system is responding to the higher or lower health needs or preferences of people in different areas,” Duggan declared. “But these very large differences we are seeing suggest some of this variation may be unwarranted.
“The goal is appropriate care: the right care for the right person at the right time.”