Impact of Endometriosis Diagnostic Delays on Healthcare Resource Utilization and Costs

Eric S. Surrey, Eric Surrey, Ahmed M Soliman, Helen Trenz, Cori Blauer‐Peterson, Cori Blauer-Peterson, Ashley Sluis
Advances in therapy · 2020 · vol. 37(3) , pp. 1087–1099 · doi:10.1007/s12325-019-01215-x · PMID:31960340 · W3003144693
article OA: hybrid CC0 ⤵ 94 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Longer diagnostic delays for endometriosis correlated with increased pre-diagnosis healthcare utilization, including emergency visits and hospitalizations, and higher overall healthcare costs.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective database study used Optum Research Database claims (US adults aged 18–49 with an endometriosis diagnosis between 2004 and 2016) to evaluate how diagnostic delay length (≤1 year, 1–3 years, or 3–5 years from first recorded endometriosis symptom) affects healthcare utilization and costs in the 60 months before diagnosis. Patients had continuous health-plan enrollment and at least one endometriosis symptom-related claim pre-diagnosis, with exclusions intended to reduce confounding from infections, inflammatory bowel disease, and other genitourinary/intra-abdominal conditions. Patients with intermediate or long delays had more pre-diagnosis emergency visits and inpatient hospitalizations and higher all-cause costs ($21,489 vs $30,030 vs $34,460 for short, intermediate, and long delays), with endometriosis-related costs following a similar pattern (about 12.5% of all-cause costs). A key caveat is that delay cohorts are based on claims timing and captured symptoms/diagnoses, which may not fully reflect true symptom onset or clinical course. This paper is centrally about endometriosis — it quantifies how longer endometriosis diagnostic delays increase pre-diagnosis healthcare utilization and costs.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

INTRODUCTION: Endometriosis symptoms are nonspecific and overlap with other gynecologic and gastrointestinal diseases, leading to long diagnostic delays. The burden of endometriosis has been documented; however, little is known about the impact of diagnostic delays on healthcare costs leading up to diagnoses. The purpose of this study was to examine the economic impact of diagnostic delays on pre-diagnosis healthcare utilization and costs among patients with endometriosis. METHODS: This was a retrospective database study of adult patients with a diagnosis of endometriosis from 1 January 2004 to 31 July 2016. Patients had continuous health plan enrollment 60 months prior to and 12 months following the earliest endometriosis diagnosis and ≥ 1 pre-diagnosis endometriosis symptom (dyspareunia, generalized pelvic pain, abdominal pain, dysmenorrhea, or infertility). Patients were assigned to short (≤ 1 year), intermediate (1-3 years), or long (3-5 years) delay cohorts based on the length of their diagnostic delay (time from first symptom to diagnosis). Healthcare resource utilization and costs were calculated and compared by cohort in the 60-month pre-diagnosis period. RESULTS: A total of 11,793 patients were included in the study, of which 37.7% (4446/11,793), 27.0% (3179/11,793), and 35.3% (4168/11,793) had short, intermediate, and long delays, respectively. Patients with intermediate or long diagnostic delays had consistently more all-cause and endometriosis-related emergency visits and inpatient hospitalizations in the pre-diagnosis period than patients with short delays. Pre-diagnosis all-cause healthcare costs were significantly higher among patients with longer diagnostic delays, averaging $21,489, $30,030, and $34,460 among patients with a short, intermediate, and long delay, respectively (p < 0.001 for all pairwise comparisons). Endometriosis-related costs accounted for 12.5% ($3553/$28,376) of all-cause costs and followed a similar pattern. CONCLUSION: Patients with endometriosis who had longer diagnostic delays had more pre-diagnosis endometriosis-related symptoms and higher pre-diagnosis healthcare utilization and costs compared with patients who were diagnosed earlier after symptom onset, providing evidence in support of earlier diagnosis.

My notes (saved in your browser only)

Condition tags

mesh:D004715endometriosisdysmenorrheadyspareuniainfertility

MeSH descriptors

Delayed Diagnosis Endometriosis Health Expenditures Patient Acceptance of Health Care Adult Delayed Diagnosis Emergency Service, Hospital Emergency Service, Hospital Endometriosis Female Health Expenditures Hospitalization Hospitalization Humans Longitudinal Studies Middle Aged Patient Acceptance of Health Care Retrospective Studies Severity of Illness Index Socioeconomic Factors

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (21)

Cited by (50)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:22:17.025735+00:00
License: CC0 · commercial use OK