Pelvic inflammatory disease: trends in hospitalizations and office visits, 1979 through 1988.

Objectives: We attempted to assess trends in pelvic inflammatory disease occurrence and to describe current antibiotic treatment and use of surgical procedures for pelvic inflammatory disease in the United States.

Study Design: Analyses of hospitalizations according to the National Center for Health Statistics, National Hospital Discharge Survey for 1979 to 1988, and of office visits to private physicians from the National Disease and Therapeutic Index for 1979 to 1989 were done.

Results: From 1979 to 1988, a mean of 181,700 women aged 15 to 44 years were hospitalized each year for acute pelvic inflammatory disease (3.03/1000 women) and 94,400 for chronic pelvic inflammatory disease (0.90/1000), and nearly 400,000 first visits for pelvic inflammatory disease were made each year to private physicians' offices (7.2/1000 women). Mean visit and hospitalization rates for acute pelvic inflammatory disease were highest for women aged 20 to 24 years and for other-than-white women. By 1987 to 1988, however, pelvic inflammatory disease hospitalization rates were highest for teenagers. Surgery was performed during 42% of hospitalizations for acute pelvic inflammatory disease and 90% of hospitalizations for chronic pelvic inflammatory disease. Over this time period, hospitalization rates for acute pelvic inflammatory disease decreased by 36% while office visit rates remained unchanged.

Conclusion: This decrease in hospitalizations for pelvic inflammatory disease may indicate a true decrease in its incidence, changes in physician hospitalization practices, or a shift in the spectrum of severity of pelvic inflammatory disease.