Pd24-09 Are There Socioeconomic Disparities in Pelvic Organ Prolapse Surgery in a Managed Care Setting?

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Pelvic Organ Prolapse and Reconstructive Surgery (Including Non-trauma Related Fistula and Urethral Diverticulum) (PD24) 1 May 2024PD24-09 ARE THERE SOCIOECONOMIC DISPARITIES IN PELVIC ORGAN PROLAPSE SURGERY IN A MANAGED CARE SETTING? Krystal A. DePorto, Samantha DeAndrade, Kaitlin Crawford, Botao Zhou, and Christopher Tenggardjaja Krystal A. DePortoKrystal A. DePorto, Samantha DeAndradeSamantha DeAndrade, Kaitlin CrawfordKaitlin Crawford, Botao ZhouBotao Zhou, and Christopher TenggardjajaChristopher Tenggardjaja View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008840. 07763. 8d. 09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Racial and ethnic disparities have been observed in mode of pelvic organ prolapse surgery. It is hypothesized that some of the disparities may be attributable to differences in access to care and advanced surgical technology across the United States. We aimed to investigate whether racial and ethnic disparities in a mode of prolapse surgery can still be observed in a managed care setting. METHODS: This is a retrospective cohort study of patients who underwent apical pelvic organ prolapse surgery within Kaiser Permanente Southern California between 2014 and 2017. Patient demographic information, comorbidities, prolapse stage, concomitant surgeries and 30-day complications were abstracted from the electronic medical record. Chi square tests and logistic regression were performed. RESULTS: In total 4, 250 patients across 19 medical centers underwent apical prolapse surgery. Prolapse stage was unable to be extracted for 702 patients, therefore 3, 548 patients were included in the final analysis. Of those, 37% identify as non-Hispanic White, 5. 3% non-Hispanic Black, 51. 9% Hispanic/Latina, 5. 2% Asian, 0. 1% American Indian or Alaskan Native, 0. 2% Native Hawaiian or Pacific Islander, 0. 6% multiracial, and 0. 1% other. 20% of the sample reported an annual household income of >80, 000, 20% reported 60, 001-80, 000, 28. 4% reported 40, 001 to 60, 000, 17. 3% reported <40, 000, and 14. 4% were unknown. The procedures performed were vaginal uterosacral ligament suspension (n=2, 187), minimally invasive sacrocolpopexy (n=777), colpocleisis (n=345), sacrospinous ligament suspension (n=188), laparoscopic uterosacral ligament suspension (n=41) and abdominal sacrocolpopexy (n=10). Compared to white women, Latina women were less likely to undergo a vaginal native tissue repair versus sacrocolpopexy (OR 0. 76, 95% CI 0. 64 - 0. 91). However, when adjusted for age, education level, smoking status, comorbidities, concurrent hysterectomy or incontinence procedure, prolapse stage and medical center, there were no significant differences observed by race/ethnicity or income level. CONCLUSIONS: Within this managed care setting, no disparities in mode of apical prolapse surgery were observed by race/ethnicity or income level when providers and patient-level confounders such as prolapse stage and comorbidities were controlled for. This may suggest that a significant driver of racial/ethnic disparities observed in prolapse surgery may be attributable to structural level factors such as regional practice patterns and patient access to advanced surgical technologies. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e534 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Krystal A. DePorto More articles by this author Samantha DeAndrade More articles by this author Kaitlin Crawford More articles by this author Botao Zhou More articles by this author Christopher Tenggardjaja More articles by this author Expand All Advertisement PDF downloadLoading. . .