Cost comparison of gynecologic procedures between the US and a developing country: an observational study

Abstract

The Unites States spends on healthcare, with women’s health being included, more than what middle-to-low-income countries, such as Lebanon, do. Compared to the United States, Lebanon has negligible data on the amounts spent on healthcare including female health services. In this study, we try to assess the cost differences of common gynecologic procedures between Lebanon and the United States, trying to fill the gap of missing data in Lebanon and identifying potential factors that can lead to high healthcare cost in the United States. Retrospective chart review. Chart review in Lebanon and surgery cost estimate in the US. A total of 505 patients was included in Lebanon, where patients were divided into 3 classes of insurance depending on the services provided. Cost of common gynecologic procedures in US dollars. The data collected were stratified according to insurance statuses of the patients. Using the ANOVA test, a comparison was performed between different insurance categories of patients in the US and patients in Lebanon. Forty percent of Lebanese patients were covered by second-class insurance. Total abdominal hysterectomy with removal of corpus and cervix was the most common gynecologic procedure. In addition, there was a significant difference in the mean total bill between first-class and third-class insured patients. When comparing Lebanon to the United States, the mean total bill was significantly higher for insured and non-insured United States patients than patients in Lebanon, except for open myomectomy where the difference between the mean total bill in Lebanon and the United States was nonsignificant. There is a significant difference in the cost of Cesarean delivery, sub-classes of hysterectomy, and laparoscopic myomectomy between Lebanon and the United States, even when patients are classified according to their insurance status, which necessitates interventions in the United States to cut down costs. © 2021, The Author(s), under exclusive licence to Springer-Verlag London Ltd. part of Springer Nature.