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Kristen H Kjerulff, PhD, Johns Hopkins School of Medicine, Department of Gynecology and Obstetrics, 600 North Wolfe Street/Harvey 319, Baltimore, MD 21287, 410-614-4495, kkjerul1@jhmi.edu and Kevin D. Frick, PhD, Department of Health Policy and Management, Johns Hopkins University, 624 N. Broadway, Rm. 606, Baltimore, MD 21205.
Objective: The purpose of this study was to estimate health care utilization and expenditures associated with the presence of gynecologic disorders among American women and to assess the impact of health insurance, employment, income and race on these factors. Methods: The estimates were derived from the 2000 Medical Expenditure Panel Survey (MEPS), a national survey of 25,096 individuals, which includes responses from 9,729 females aged 14 and older. Weights were used to estimate the number of American women who have one or more gynecologic disorders annually; the number of ambulatory care visits, prescription medications filled, emergency room visits and hospital stays associated with these gynecologic disorders; the associated expenditures for each type of utilization and overall. We used multiple linear and logistic regression equations to estimate the effects of health insurance, employment, income and race on health care utilization and expenditures, controlling for age and other non-gynecologic chronic conditions. Results: 12.4% of females aged 14 and older reported a gynecologic disorder, the most common of which were menopausal disorders, other female genital disorders, and menstrual disorders. The average overall medical care expenditures in 2000 among women with gynecologic disorders was $3,584. The average medical care expenditures was higher for women with public insurance only ($5,248) and private insurance ($3,383) than for women without insurance ($2,161). Hispanic women had lower expenditures than women of other racial groups (p = .0071), as did women who were employed outside of the home (p = .0669) and women with higher incomes (p = .0218), controlling for other chronic conditions and age. Women with gynecologic disorders who were uninsured were less likely to have visited a doctor in 2000 (p < .0001) and less likely to have been prescribed medications than those with insurance (p < .0001). Women with public insurance only were more likely to have visited an emergency room (p < .0001), to have been hospitalized (p < .0001), had more office visits (p = .0110) and more prescriptions (p < .0001) than women with private or no insurance, controlling for patient age and other chronic conditions. Hispanic women had fewer prescriptions than women of other races (p = .0055). Conclusions: Among women with gynecologic disorders, those with public insurance only had higher health care expenditures and utilization than women with private or no insurance coverage. Hispanic women had lower health care expenditures and fewer prescriptions than women of other races.
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Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.