Endometriosis Analysis: Current Healthcare Utilization and Costs in Women With Endometriosis [17B]

INTRODUCTION: To develop a greater understanding of endometriosis patients' clinical characteristics, provider characteristics, and costs. METHODS: Longitudinal data from a 1/1/2010–9/30/2018 national commercial claims and encounters database, were examined. Person-specific (blinded) clinical utilization, expenditures, and enrollment were examined. There were 975 patients with a confirmed endometriosis diagnosis (e.g., laparoscopy, hysterectomy, oophorectomy). Data from 5 years prior to confirmed diagnosis and 1-year after were included. RESULTS: In 5 years prior to confirmed endometriosis diagnosis 93.7% of patients visited an Ob/Gyn; 79.3% family medicine; and 52.9% emergency medicine. More than half the patients (60.1%) visited an emergency room (mean 3.46 visits). Approximately 27% had visits to a chiropractic office (mean 17.94 visits over 5 years); 17.6% had physical therapy (mean 10.53 visits). Confirmed diagnosis averaged 984 days (2.7 years) from initial symptoms. Diagnoses for painful periods, heavy menses, infertility, and intercourse pain increased in the year before diagnosis. Oral contraceptive was the most common hormonal therapy. Gonadotropin use was 0.8% prior to diagnosis;12.4% in 6 months following; declined to 8.2% in the next 6 months. Average annual costs in years 5–2 prior to diagnosis were $4, 318; $6,791 year immediately prior to diagnosis; $17,230 in first 6 months post-diagnosis; and $6,129 in months 7–12 post-diagnosis. CONCLUSION: This analysis provides insight into patient clinical needs leading up to and following confirmed diagnosis of endometriosis. Understanding these characteristics may lead to more efficient healthcare utilization and lower costs.