Abstract No. 396 Healthcare Disparities and Uterine Artery Embolization: Do Race and Socioeconomic Status Matter?

To identify any potential social determinants of health that may impact utilization of UAE for treatment of symptomatic uterine fibroids. Data from the 2011 to 2020 National Inpatient Sample were analyzed using ICD 9 and 10 procedural and diagnostic codes. Patients with symptomatic uterine fibroids who underwent UAE, hysterectomy, myomectomy, or endometrial ablation, were investigated. Data collected included: income, race, hospital type, region of hospital, and insurance status. Results were analyzed using SPC charts and Chi-square testing. Non-Hispanic Blacks consistently accounted for the greatest percentage of UAE procedures (45.6% of all UAE procedures), followed by non-Hispanic whites (28.1%) and Hispanics (14.2%). Patients in the lowest quartile for income steadily held the highest share of UAE procedures (27.8%), while the highest quartile gradually decreased across the decade (2011: 26.7%, 2020: 19.0%). The Northeast region of the United States originally accounted for a majority of the UAE procedures peaking at 56.7% in 2013; however, this gradually declined as ultimately the South became the predominant region by the end of the decade responsible for 34.6% of all UAE. Private insurance and Medicare made up a majority of the primary payers throughout the decade, averaging 55.5% and 26.2% respectively. Finally, urban teaching hospitals accounted for the highest rates of total UAE (82.3%), compared to urban non-teaching (16.0%) and rural hospitals (1.2%). Over the past decade, UAE has been disproportionately underutilized in the Hispanic population when considering the unequal disease burden when compared with non-Hispanic whites. Notably, non-Hispanic Blacks were not disadvantaged despite a higher disease burden. Urban teaching hospitals disproportionally accounted for a majority of UAE procedures. In regard to income and insurance status, distribution was relatively equitable. As the utilization of UAE grows, it is important to continue a dedicated effort to serve in an equitable manner.