Nationwide Cost of Pelvic Organ Prolapse Surgery in the United States

Objective:
To obtain an updated estimate of the national cost of pelvic organ prolapse (POP) surgery in the United States and understand the population receiving surgery.

Methods:
In this cross-sectional, population-based study, we used the 2016 to 2018 Healthcare Cost and Utilization Project National Inpatient Samples and National Ambulatory Surgery Samples to identify patients undergoing POP surgery using ICD-10 diagnosis codes, ICD-10 procedural codes and CPT codes. Cost-to-charge ratios and weighted estimates were used to calculate nationwide costs. Descriptive analysis was used to identify the socio-demographic, clinical, and surgical characteristics of the population undergoing POP surgery.

Results:
Between 2016 and 2018, there were 140,762 POP surgical cases annually with an annual national cost estimated at $1.523 billion dollars per year. The median cost per procedure increased slightly from $8,837 in 2016 to $8,958 in 2018. Overall, 82.5% of the total surgeries and 74% of the total national costs associated with POP surgery came from the ambulatory setting over this time period. Of these surgeries, 44.7% included an apical repair, and 42.3% included a concomitant hysterectomy. The average age of the population was 62, and 20% of the total population receiving prolapse surgery was < 50 years.

Conclusion:
The annual national cost associated with surgical correction of POP is substantial, and the majority of cases occur in an ambulatory setting. These findings will contribute to enhancing cost-effectiveness analyses and decision-making processes for both healthcare providers and policymakers as the national population continues to age.