Disparities in healthcare services in women with endometriosis with public vs private health insurance.
Am J Obstet Gynecol
; 221(6): 623.e1-623.e11, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31226295
ABSTRACT
BACKGROUND:
The goals of health disparities research are to identify facilitators and barriers to healthcare use to help eliminate health inequalities. There are few studies on disparities in healthcare access and use trends for patients with endometriosis that may lead to differences in appropriate care based on socioeconomic status.OBJECTIVE:
This retrospective, cross-sectional study was conducted to compare health services use patterns and prevalence of co-morbidities of women with endometriosis with public (government-based) vs private (purchased or provided by employer) health insurance. STUDYDESIGN:
A total of 342 deidentified datasets (171 randomly-selected cases per study group) from women with endometriosis 14-50 years old who were members of one health insurance company that provides both public and private health insurance coverage in Puerto Rico were analyzed. Patients were defined as having at least 1 endometriosis-related medical claim (ICD-9-617.xx; International Classification of Diseases, Ninth Revision, Clinical Modification) during the 3-year study period.RESULTS:
Medical service (eg, hospital, laboratory, pathology, and radiology) use trends were 3 times lower in the public vs the private sector. Women in the public sector were 3.5 times less likely to have a laparoscopy, 2.7 times more likely to be prescribed opioid/narcotics, and were the only study subjects reporting emergency department use. Obstetrics and gynecology services were used >2-fold less by women in the public (29.5%) vs the private sector (70.5%) (P=.087).CONCLUSIONS:
We report significant differences in the use trends of endometriosis-related medical services and prescriptions, indicating differences in healthcare access based on socioeconomic parameters. Our results support the development of public health programs to promote access to healthcare for patients with endometriosis irrespective of socioeconomic status and promote health disparity research in other healthcare systems.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Medicaid
/
Setor Privado
/
Endometriose
/
Disparidades em Assistência à Saúde
/
Seguro Saúde
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
País/Região como assunto:
America do norte
/
Caribe
/
Puerto rico
Idioma:
En
Revista:
Am J Obstet Gynecol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Porto Rico