Urogynecology (Philadelphia, Pa.) · 2025
Variation in Overactive Bladder Treatment Type by Social Determinants of Health.
СтатьяНазвание и аннотация: Перевод в очереди
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Muñoz Jaclyn M, Kim Edward K, Andy Uduak U, Mumford Sunni L, Harvie Heidi S
Аннотация
IMPORTANCE: There is limited understanding of the relationship between social determinants of health (SDOH) and types of overactive bladder/urgency urinary incontinence (OAB/UUI) treatments.
OBJECTIVES: Our objective was to determine if OAB/UUI treatment type differs by SDOH, including insurance and estimated median household income (EMHI).
STUDY DESIGN: This was a cross-sectional study of adult patients assigned female at birth with OAB/UUI, identified from 2017 to 2022 within a tertiary academic health system. The primary outcome was any OAB/UUI treatment provision. Secondary outcomes included specific treatments and specialty care. We examined associations between SDOH and OAB/UUI treatments using univariable analysis and multivariable logistic regression.
RESULTS: Among 33,002 patients with OAB/UUI, 15.4% received treatment. Treatment provision was associated with American Indian/Alaska Native or Black/African American race, Latina ethnicity, Medicaid, low-income Medicare, or Medicare Advantage (vs private insurance) and EMHI ranging from $26,500 to $100,000 (compared with EMHI >$100,000). Patients with Black/African American race, Medicaid or no insurance, and EMHI ≤$80,000 had higher odds of anticholinergic prescription and lower odds of β 3 -agonist prescription. Advanced therapy was associated with traditional Medicare, Medicare Advantage, and EMHI $26,500-$100,000 and negatively associated with Asian race. Specialty care was associated with Black/African American race, Medicaid, Medicare Advantage, no insurance, and EMHI ≤$80,000.
CONCLUSIONS: Overactive bladder/urgency urinary incontinence treatment provision was associated with American Indian/Alaska Native and Black/African American race, Latina ethnicity, Medicaid, low-income Medicare, or Medicare Advantage insurance. Patients with Black/African American race and with lower EMHI had higher odds of receiving anticholinergic therapy and lower odds of receiving β 3 -agonist medication, despite higher likelihood of specialty care.
OBJECTIVES: Our objective was to determine if OAB/UUI treatment type differs by SDOH, including insurance and estimated median household income (EMHI).
STUDY DESIGN: This was a cross-sectional study of adult patients assigned female at birth with OAB/UUI, identified from 2017 to 2022 within a tertiary academic health system. The primary outcome was any OAB/UUI treatment provision. Secondary outcomes included specific treatments and specialty care. We examined associations between SDOH and OAB/UUI treatments using univariable analysis and multivariable logistic regression.
RESULTS: Among 33,002 patients with OAB/UUI, 15.4% received treatment. Treatment provision was associated with American Indian/Alaska Native or Black/African American race, Latina ethnicity, Medicaid, low-income Medicare, or Medicare Advantage (vs private insurance) and EMHI ranging from $26,500 to $100,000 (compared with EMHI >$100,000). Patients with Black/African American race, Medicaid or no insurance, and EMHI ≤$80,000 had higher odds of anticholinergic prescription and lower odds of β 3 -agonist prescription. Advanced therapy was associated with traditional Medicare, Medicare Advantage, and EMHI $26,500-$100,000 and negatively associated with Asian race. Specialty care was associated with Black/African American race, Medicaid, Medicare Advantage, no insurance, and EMHI ≤$80,000.
CONCLUSIONS: Overactive bladder/urgency urinary incontinence treatment provision was associated with American Indian/Alaska Native and Black/African American race, Latina ethnicity, Medicaid, low-income Medicare, or Medicare Advantage insurance. Patients with Black/African American race and with lower EMHI had higher odds of receiving anticholinergic therapy and lower odds of receiving β 3 -agonist medication, despite higher likelihood of specialty care.