Ijeoma Agu1,2, Fiona K Smith3,4, Shivani Murarka5, Jiaqiong Xu6, Gazala Siddiqui3,4, Francisco Orejuela5, Tristi W Muir3,4, Danielle D Antosh3,4. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center, Houston, TX, USA. ijeoma_agu@med.unc.edu. 2. Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, USA. ijeoma_agu@med.unc.edu. 3. Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center, Houston, TX, USA. 4. Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, USA. 5. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA. 6. Center for Outcome Research, Houston Methodist Hospital Research Institute, Houston, TX, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: The objectives were to determine whether a difference exists in the duration of pelvic floor disorder (PFD) symptoms among patients presenting to urogynecologists in two healthcare systems: private and county; and to elucidate differences in baseline characteristics, type of PFDs, symptom severity and management, stratified by healthcare plans. METHODS: A multi-center retrospective study was conducted including new patients presenting to three urogynecology clinics between March 2016 and May 2018: one private clinic (site A) and two public clinics in the same county healthcare system (sites B and C). Baseline data included age, race, BMI, parity, and comorbidities. Primary outcome was "time to presentation" defined as PFD duration in months. Secondary outcomes were symptom severity and PFD management, analyzed by healthcare setting and insurance type. RESULTS: A total of 1,055 private and 439 public patients were included. Patients in the public setting were younger (54 vs 61 years, p<0.001), largely Hispanic (76% vs 14%, p<0.001), of higher parity (4 vs 3, p=0.001), and had more comorbidities, with a predominance of county-funded healthcare plans. There was no difference in duration of symptoms between the public and private groups respectively (54 vs 56 months, p=0.94). Patients in the public setting had more severe urinary incontinence (3 vs 2 pads/day, p<0.001) and prolapse (stages 3-4, 71% vs 61%, p=0.004); however, they had lower rates of surgical management for stress incontinence and prolapse. Differences in fecal incontinence could not be evaluated owing to small sample size. CONCLUSIONS: Public patients presented younger with more severe symptoms but had lower rates of surgery for PFDs traditionally managed surgically.
INTRODUCTION AND HYPOTHESIS: The objectives were to determine whether a difference exists in the duration of pelvic floor disorder (PFD) symptoms among patients presenting to urogynecologists in two healthcare systems: private and county; and to elucidate differences in baseline characteristics, type of PFDs, symptom severity and management, stratified by healthcare plans. METHODS: A multi-center retrospective study was conducted including new patients presenting to three urogynecology clinics between March 2016 and May 2018: one private clinic (site A) and two public clinics in the same county healthcare system (sites B and C). Baseline data included age, race, BMI, parity, and comorbidities. Primary outcome was "time to presentation" defined as PFD duration in months. Secondary outcomes were symptom severity and PFD management, analyzed by healthcare setting and insurance type. RESULTS: A total of 1,055 private and 439 public patients were included. Patients in the public setting were younger (54 vs 61 years, p<0.001), largely Hispanic (76% vs 14%, p<0.001), of higher parity (4 vs 3, p=0.001), and had more comorbidities, with a predominance of county-funded healthcare plans. There was no difference in duration of symptoms between the public and private groups respectively (54 vs 56 months, p=0.94). Patients in the public setting had more severe urinary incontinence (3 vs 2 pads/day, p<0.001) and prolapse (stages 3-4, 71% vs 61%, p=0.004); however, they had lower rates of surgical management for stress incontinence and prolapse. Differences in fecal incontinence could not be evaluated owing to small sample size. CONCLUSIONS: Public patients presented younger with more severe symptoms but had lower rates of surgery for PFDs traditionally managed surgically.
Authors: Blair B Washington; Christina A Raker; Kavita Mishra; Vivian W Sung Journal: Female Pelvic Med Reconstr Surg Date: 2013 Mar-Apr Impact factor: 2.091
Authors: Jennifer E Devoe; Alia Baez; Heather Angier; Lisa Krois; Christine Edlund; Patricia A Carney Journal: Ann Fam Med Date: 2007 Nov-Dec Impact factor: 5.166