Women With Polycystic Ovary Syndrome Utilize Primary Care More Than Specialty Services

Purpose PCOS is associated with adverse health outcomes, patient dissatisfaction, and high healthcare costs, yet no study has simultaneously compared healthcare utilization across the full spectrum of ambulatory clinicians who care for affected women. Characterizing this utilization can direct educational interventions to improve diagnosis and management of PCOS and its multisystem comorbidities. Methods We conducted a retrospective cohort study using an employer-sponsored commercial insurance database for the year 2020. PCOS cases were identified using validated ICD-10-CM codes. Control women lacked inclusion codes and codes for androgen excess (E28.1), acne (L70), infertility (N97), alopecia (L65.9), and menstrual disorders (N92). We compared the percentage of PCOS cases and controls who had at least one annual visit to a given provider. We also investigated the 15 diagnosis codes most frequently associated with cardiology visits. Results There were 98,550 PCOS cases and 3,150,661 controls. Median age was 29 years in both cohorts. Significantly more PCOS cases had at least one annual visit to primary care (78% vs 59%), obstetrics and gynecology (59% vs 33%), endocrinology (15% vs 2%), dermatology (13% vs 7%), supportive therapy (10% vs 7%), cardiology (8% vs 5%), gastroenterology (6% vs 3%), surgery (5% vs 2%), neurology (5% vs 3%), and pulmonology (2% vs 1%). The cardiology visit diagnoses were similar in both groups. Conclusions Women with PCOS utilized more healthcare services provided by primary care and multiple specialists not traditionally associated with the syndrome. These clinicians should be targeted for educational interventions to improve recognition of PCOS and its comorbidities.