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Hysterectomy or tubal ligation for sterilization: a cost-effectiveness analysis.

A model has been developed to compare tubal ligation using the Pomeroy procedure and vaginal or abdominal hysterectomies in the nonpregnant patient. All quantifiable effects attributable to the 2 procedures are included. The analysis concludes that except for those individuals who exhibit overriding extenuating circumstances the choice should always be tubal ligation regardless of the age of the patient at the time of the procedure and as long as the applicable rate of discount is between 5-15%. Considerable savings should accrue to the individual government programs and society in general if prospective patients physicians and government policy makers exercise this choice. The cost-savings to society for each tubal ligation chosen in preference to a hysterectomy varies between $200-400.