Disparities in Access to Uterine Artery Embolization versus Hysterectomy: A 7-year National Cross-Sectional Study

Sunday, April 12, 2026

3:09 PM - 3:18 PM ET

Location: 716B

Presenting Author(s)

Trisha Venkat (she/her/hers)

Medical Student
UMass Chan School of Medicine, United States

Author/Co-author(s)

DD

Dania Daye, MD, PhD

Associate Professor
University of Wisconsin School of Medicine and Public Health, United States
AN

Anand K. Narayan, MD, PhD

Professor, Vice Chair, Equity
Department of Radiology, University of Wisconsin - Madison, United States
MD

Michael Dezube

Senior Data Scientist
Massachusetts General Hospital, United States
TE

Tarig Elhakim, MD

Medicine Instructor & Research Associate
Penn (Medicine Instructor) & MGH (Research Associate), United States

Purpose: Evaluate differences in utilization of uterine artery embolization (UAE) vs hysterectomy for the management of Postpartum Hemorrhage across socioeconomic, demographic, and institutional factors.

Materials and Methods: This cross-sectional study used deidentified patient data from the National Inpatient Sample between the years of 2016 to 2022. Adult patients with a diagnosis of postpartum hemorrhage were identified based on the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic codes and further filtered to patients treated with either UAE or hysterectomy based on the ICD-10 Procedure Coding System. A multivariable logistic regression model was created to identify the differences in utilization of each procedure by demographics, socioeconomics, and geography.

Results: A total of 17,275 hospital admissions were identified, among which 9,165 had hysterectomies and 8,110 had UAEs. The median age was 33 years in both the UAE and hysterectomy groups. The patient sample was 44.6% White, 16.8% Black, 22.6% Hispanic, 10.5% Asian, 0.8% Native American and 4.7% other. Compared to Whites, there was no significant difference in UAE utilization over hysterectomy by race. However, compared to private insurance, patients with Medicaid had 29% lower odds of receiving a UAE than a hysterectomy (OR=0.71, 95% CI: 0.60-0.85, p< 0.001). Compared to patients in the 76-100th income quartile, those in the 0-25th and 26-50th income quartiles were less likely to receive UAE than hysterectomy (OR=0.63, 95% CI: 0.50-0.80, p< 0.001 and OR=0.72, 95% CI: 0.57-0.90, p=0.004, respectively). Compared to patients living in the most central counties, those living in the most rural counties were less likely to receive UAE vs hysterectomy (OR=0.50, 95% CI: 0.30 to 0.83, p=0.007). Compared to patients in rural hospitals, those in an urban teaching hospital were more likely to receive UAE than hysterectomy (OR=5.70, 95% CI: 2.95-11.0, p< 0.001). UAE utilization increased from a total of 760 procedures in 2016 (27.2% of procedures vs hysterectomy to treat postpartum hemorrhage) to 1,555 (54.9%) in 2022.

Conclusion: Following postpartum hemorrhage, patients in rural regions, lower-income quartiles, or with Medicaid insurance were less likely to receive UAE than hysterectomy. These disparities highlight the urgent need for policy reforms to ensure equitable patient care.