{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:41:12Z","timestamp":1772696472235,"version":"3.50.1"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Helsinki University Library"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>The impact of benign gynecological conditions on life of women and on costs for the society is high. The purpose of this study is to gain knowledge and understanding of costs of the treatment of these disorders in order to be able to improve the clinical care processes, gain insight into feasible savings opportunities and to allocate funds wisely.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The healthcare processes of 311 women attending university or community hospitals in the Helsinki and Uusimaa Hospital District between June 2012 and August 2013 due to a benign gynecological condition were followed up for two years and treatment costs analysed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Total direct hospital costs averaged 689\u20ac at six months and 2194\u20ac at two years. The most expensive treatment was that of uterine fibroids in the short term and that of endometriosis and fibroids later on. Costs did not depend on hospital size. Surgical operations caused nearly half of hospital costs. Productivity loss caused biggest expenses outside of the hospital. LNG-IUD (levonorgestrel-releasing intrauterine device) accounted for the largest pharmaceutical costs for patients. Hospital treatment was associated with a reduced need for outpatient services during follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>A majority of direct hospital costs arise over time. This stresses the need for prolonged healthcare management. To control costs, the need for repetitive doctors\u2019 appointments, monitoring tests, and ward treatments should be carefully evaluated. Procedures not needing an operation theatre (for example hysteroscopy for polypectomy), should be done ambulatorily.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0254124","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T18:16:23Z","timestamp":1625854583000},"page":"e0254124","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Where does the money go to? Cost analysis of gynecological patients with a benign condition"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-0730","authenticated-orcid":true,"given":"Kristiina","family":"Pynn\u00e4","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pirjo","family":"R\u00e4s\u00e4nen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Risto P.","family":"Roine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piia","family":"Vuorela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1252-0946","authenticated-orcid":true,"given":"Harri","family":"Sintonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,7,9]]},"reference":[{"issue":"2","key":"pone.0254124.ref001","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1067\/mob.2002.124940","article-title":"Health-related quality of life measurement in women with common benign gynecologic conditions: a systematic review","volume":"187","author":"GL Jones","year":"2002","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"pone.0254124.ref002","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.3109\/00016340903317990","article-title":"Costs and health-related quality of life effects of hysterectomy in patients with benign uterine disorders","volume":"88","author":"K Taipale","year":"2009","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"3","key":"pone.0254124.ref003","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/aogs.12299","article-title":"Cost-effectiveness of hysterectomy for benign gynecological conditions: a systematic review","volume":"93","author":"K Pynn\u00e4","year":"2013","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"2","key":"pone.0254124.ref004","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ajog.2015.03.019","article-title":"The direct and indirect costs of uterine fibroid tumors: a systematic review of the literature between 2000 and 2013","volume":"213","author":"AM Soliman","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"pone.0254124.ref005","first-page":"102","article-title":"Estimated hospital health costs of chronic abdominal pain in the Netherlands","volume":"72","author":"LA Jansen","year":"2014","journal-title":"Neth J Med"},{"issue":"4","key":"pone.0254124.ref006","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1093\/humrep\/dev335","article-title":"The direct and indirect costs associated with endometriosis: a systematic literature review","volume":"31","author":"AM Soliman","year":"2016","journal-title":"Hum Reprod"},{"issue":"2","key":"pone.0254124.ref007","doi-asserted-by":"crossref","first-page":"195","DOI":"10.2105\/AJPH.86.2.195","article-title":"Chronic gynecological conditions reported by US women: findings from the National Health Interview Survey, 1984 to 1992","volume":"86","author":"KH Kjerulff","year":"1996","journal-title":"Am J Public Health"},{"issue":"3","key":"pone.0254124.ref008","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/j.1524-4733.2007.00168.x","article-title":"A systematic review evaluating health-related quality of life, work impairment and health-care costs and utilization in abnormal uterine bleeding","volume":"10","author":"Z Liu","year":"2007","journal-title":"Value Health"},{"issue":"1","key":"pone.0254124.ref009","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1757-2215-5-29","article-title":"Health-related quality of life in women with endometriosis: a systematic review","volume":"5","author":"SZ Jia","year":"2012","journal-title":"J Ovarian Res"},{"issue":"3","key":"pone.0254124.ref010","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s00404-013-2793-0","article-title":"Costs of endometriosis in Austria: a survey of direct and indirect costs","volume":"288","author":"J Prast","year":"2013","journal-title":"Arch Gynecol Obstet"},{"issue":"5","key":"pone.0254124.ref011","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1093\/humrep\/des073","article-title":"The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres","volume":"27","author":"S Simoens","year":"2012","journal-title":"Hum Reprod"},{"issue":"4","key":"pone.0254124.ref012","first-page":"395","article-title":"Endometriosis: cost estimates and methodological perspective","volume":"13","author":"S Simoens","year":"2007","journal-title":"Hum Reprod"},{"key":"pone.0254124.ref013","unstructured":"Centers for Medicaid and Medicare Services: National Health Expenditures 2014 [Cited 2020, August 10]. 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Results from an 11 year prospective observational study","volume":"57","author":"T Ma","year":"2017","journal-title":"Aust N Z J Obstet Gynaecol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0254124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T18:16:59Z","timestamp":1625854619000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0254124"}},"subtitle":[],"editor":[{"given":"Stanley J.","family":"Robboy","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,7,9]]},"references-count":19,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0254124","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,9]]}}}