Disparities in healthcare services in women with endometriosis with public vs private health insurance

Jessica Fourquet, Fourquet J, Diego E. Zavala, Zavala DE, Missmer S, Stacey A. Missmer, Stacey Missmer, Nabal Bracero, Bracero N, Romaguera J, Josefina Romaguera, Idhaliz Flores
American journal of obstetrics and gynecology · 2019 · vol. 221(6) , pp. 623.e1–623.e11 · doi:10.1016/j.ajog.2019.06.020 · PMID:31226295 · W2950843355
article OA: bronze CC0 ⤵ 18 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This study investigated disparities in healthcare access and quality for women with endometriosis based on their public versus private health insurance status.

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Abstract

BackgroundThe 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.ObjectiveThis 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.Study designA 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.ResultsMedical 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).ConclusionsWe 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.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Healthcare Disparities Insurance, Health Medicaid Private Sector Adult Analgesics, Opioid Analgesics, Opioid Cross-Sectional Studies Emergency Service, Hospital Emergency Service, Hospital Endometriosis Female Health Services Accessibility Humans Hysterectomy Hysterectomy Laparoscopy Laparoscopy Puerto Rico

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References (51)

Cited by (19)

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