Objective: To examine variations between regions and hospitals in the proportion of hysterectomies performed abdominally.
Design: Analysis of routine hospital data.
Setting: All National Health Service hospitals in England.
Population: Women aged 18+ hospitalised between April 1998 and March 2001.
Methods: Logistic regression, adjusting for age and diagnosis.
Main outcome measure: Use of the abdominal rather than the vaginal route.
Results: The adjusted proportion of hysterectomies performed abdominally varied from 75-89% between regions, and from 25-99% between hospitals. Diagnosis accounted for nearly a third of the total variation, dwarfing the contributions of age and hospital. About two-thirds of the variation remained unaccounted for.
Conclusion: Despite evidence suggesting that the majority of hysterectomies may be performed vaginally, very few English trust match this.