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Variation in Overactive Bladder Treatment Type by Social Determinants of Health
Jaclyn M Muñoz1, Edward K Kim2, Uduak U Andy1
1Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA.
Urogynecology (Philadelphia, Pa.)
|December 29, 2024
Summary
Social determinants of health influence overactive bladder/urgency urinary incontinence (OAB/UUI) treatment. Patients with lower income or specific insurance types received different OAB/UUI treatments, impacting medication choices.
Area of Science:
- Urology
- Health Services Research
- Health Equity
Background:
- Understanding the link between social determinants of health (SDOH) and overactive bladder/urgency urinary incontinence (OAB/UUI) treatments is limited.
- SDOH factors, such as insurance status and income, may influence treatment disparities.
Purpose of the Study:
- To investigate if OAB/UUI treatment type varies based on SDOH, specifically insurance and estimated median household income (EMHI).
Main Methods:
- A cross-sectional study analyzed data from 33,002 adult patients with OAB/UUI from 2017-2022.
- Associations between SDOH and OAB/UUI treatment provision, specific therapies, and specialty care were examined using logistic regression.
Main Results:
- Treatment provision was linked to race, ethnicity, insurance type (Medicaid, low-income Medicare, Medicare Advantage), and EMHI.
- Black/African American patients and those with lower EMHI were more likely to receive anticholinergics and less likely to receive β3-agonists.
- Advanced therapies and specialty care access also showed associations with specific SDOH factors.
Conclusions:
- OAB/UUI treatment provision and type are significantly associated with race, ethnicity, insurance, and income.
- Disparities exist, with certain populations more likely to receive specific, and potentially less optimal, OAB/UUI treatments despite accessing specialty care.
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