Benign Hysterectomy Episode and Quality Measures


Hysterectomy, the surgical removal of all or part of the uterus, is one of the most common procedures performed on women in the United States. Hysterectomies may address cervical and uterine cancer as well as a variety of benign indications.  The most common benign indications include uterine fibroids, abnormal uterine bleeding, pelvic organ prolapse, and endometriosis.  The American Congress of Obstetricians and Gynecologists (ACOG) convened a multi-stakeholder panel to develop an episode group and corresponding performance measures for hysterectomy for benign indications.  You can read more about the trends in care delivery related to hysterectomy for benign conditions and the evidence behind some of the choices the panel made.  ACOG has developed an episode for benign hysterectomy that is triggered by the surgery and will last 45 days.  ACOG sought feedback on the services that trigger the episode, the services and diagnoses that are included in the episode, the sequelae that obstetrician-gynecologists (ob-gyns) will be responsible for during the episode, and the length of the episode.  ACOG is currently revising the episode based on the feedback we received.

Review the services and codes that are in the benign hysterectomy episode.

ACOG also sought comment on the design of quality measures that will be included as a part of the episode, which are meant to assess ob-gyns’ performance and determine whether high-quality care is being delivered.  You can review the performance measure concepts that the work group developed below. 

  • Measure concept for emergency room visits, inpatient admissions, and outpatient hospital visits for conditions related to the hysterectomy within 45 days of the procedure
  • Measure concept for use of non-procedural therapy for patients under age 55 with abnormal uterine bleeding (AUB) and fibroids in the year prior to the hysterectomy
  • Measure concept for oophorectomy in women under age 65 without a family history of relevant cancer

You can also review the specifications for the eligible population who have been identified as having had a hysterectomy for a benign condition.

Patient-reported outcomes (PROs) on the following areas are proposed for collection:

  • Pain
  • Regret
  • Sexual Function
  • Fatigue
  • Satisfaction

Watch a presentation that walks through why ACOG is undertaking development of an episode and attendant performance measures for benign hysterectomy and how you can provide your feedback on the proposed model and measures.

Check back soon for the revised episode and measure specifications.

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