To determine variations in the rate of inpatient and outpatient dilatation and curettage (D&C), for the treatment of early pregnancy loss, and for the diagnosis of abnormal uterine bleeding, in 17 health regions across a Canadian province.
Frequency of D&C was examined in a cohort of 1.36 million women in Alberta. All inpatient and outpatient episodes in which dilatation and curettage was used for management of early pregnancy loss and for diagnosis or treatment of abnormal uterine bleeding were included. Variations in frequency among the 17 health regions were examined.
Rates of D&Cs performed following miscarriage or pregnancy showed a 4-fold variation among the 17 regions, between women aged 20 to 34 years and 35 to 49 years. Consistency within the regions, when comparing both groups of women, was significant (r2 = 0.5542, p = 0.00006). The rates for D&C for abnormal uterine bleeding showed up to 5-fold variation among the 17 regions between women aged 20 to 34 years, 35 to 49 years, and 50 years or more. The Pearson correlation coefficient for association of rates for procedure codes 69.02 and 69.09 across the regions was 0.62 (p