Appointment Wait Times in Female Pelvic Medicine and Reconstructive Surgery: A Mystery Caller Study

Rabice, S.; Schultz, Claire; Muffly, Tyler M.

doi:10.1097/spv.0000000000001039

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…21 Similarly, a total of only 36 Female Pelvic Medicine and Reconstructive Surgery (FPMRS) practices exist across the states of Alaska, Arizona, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming combined. In comparison, 45 practices exist in the state of California alone 22 . Academic centers are more likely to accept patients who are government‐insured.…”

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

“…Notably, one in five academic practices does not have an FPMRS‐trained specialist. Of those with FPMRS specialists, median wait times for a new patient presenting with urinary incontinence were 30 days (interquartile range [IQR]: 15–51) and 26 days (IQR: 14–42) for Medicaid and Medicare insurance, respectively 22,23 . Geographic “siloing” of subspecialist physicians offering third‐line OAB therapies further isolates a group of patients who already report feelings of isolation due to their disease process.…”

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

“…In comparison, 45 practices exist in the state of California alone. 22 Academic centers are more likely to accept patients who are government-insured. Notably, one in five academic practices does not have an FPMRStrained specialist.…”

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

“…Of those with FPMRS specialists, median wait times for a new patient presenting with urinary incontinence were 30 days (interquartile range [IQR]: 15-51) and 26 days (IQR: 14-42) for Medicaid and Medicare insurance, respectively. 22,23 Geographic "siloing" of subspecialist physicians offering third-line OAB therapies further isolates a group of patients who already report feelings of isolation due to their disease process. It is furthermore important to consider local-scale residential segregation of Black and Brown people, and the associated divestment of social services including fullspectrum, subspecialist, and tertiary healthcare available in their local communities.…”

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

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Health disparities and access to advanced therapy for overactive bladder

Roselli

McKay

Nauheim

et al. 2022

Neurourology and Urodynamics

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Aims: Refractory overactive bladder (OAB) is among the most common reasons for referral to specialists in voiding dysfunction. Significant racial and ethnic disparities exist in prevalence, severity, and management of OAB, presenting care barriers for marginalized patients. We aim to explicate these disparities and explore the factors that led to their existence and persistence. We will additionally offer suggestions to mitigate such disparities and approach equitable care for our patients. Methods: This is a narrative review of pertinent articles related to health disparities in OAB. Articles on OAB prevalence stratified by race and ethnicity, and variations in treatment patterns for patients of marginalized backgrounds were identified from the PubMed database. We also included a review of evidence from governmental and historical sources to provide sociocultural context.Results: Patients from marginalized backgrounds are underrepresented in OAB literature. There appear to be differences in symptom severity and prevalence based on race. OAB severity seems closely entwined with social determinants of health. Patients from marginalized populations experience numerous care barriers impeding the treatment of OAB.Finally, White patients are more likely to receive advanced management for OAB.Conclusions: Numerous health disparities exist in the diagnosis and management of OAB. This review is grounded in societal context: health injustice in the United States ultimately stems from systemic racism.Improving our understanding of care disparities and the systems that allow them to persist will bring us closer to equity and allow our patients from marginalized backgrounds to obtain the evidence-based care they deserve.

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Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

Section: Barriers To Overactive Bladder Carementioning

confidence: 99%

See 2 more Smart Citations

Health disparities and access to advanced therapy for overactive bladder

Roselli

McKay

Nauheim

et al. 2022

Neurourology and Urodynamics

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“…[7][8][9] Previous research in Obstetrics and Gynecology found that Medicaid beneficiaries experience significantly longer wait times than commercially insured patients. 10,11 Moreover, preand post-Affordable Care Act studies reveal that Medicaid recipients typically encounter longer delays for initial appointments for care, with 1 report finding that over half of providers could not offer appointments to enrollees in Medicaid managed care programs. 4,12,13 Audit studies, commonly referred to as "mystery caller" studies, have proven effective in assessing appointment availability and patient experiences across various healthcare sectors.…”

mentioning

confidence: 99%

Insurance Status and Access to Otolaryngology Care: National Mystery Caller Study in the United States

Corbisiero,

Muffly,

Gottman

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo investigate potential differences in new patient appointment wait times for otolaryngology care based on insurance types and explore factors influencing these wait times.Study DesignA cross‐sectional audit study, using a “mystery caller” approach, analyzed with a linear mixed Poisson model to adjust for confounding factors.SettingA total of 612 physicians across 49 states and the District of Columbia, representing 6 otolaryngology subspecialties, were included.MethodsOtolaryngology physicians were contacted by mystery callers via telephone with scripted clinical vignettes as patients with either Medicaid or Blue Cross/Blue Shield (BCBS) insurance. Callers requested next available appointment. Wait times for new patient appointments were recorded and analyzed in R using a generalized linear mixed Poisson model.ResultsA total of 1183 of 1224 calls reached a representative. Medicaid patients waited 5.73% longer (P < .001) compared to BCBS patients (IRR: 1.06; confidence interval [CI]: 1.03‐1.09; P < .001), with respective mean wait times of 36.8 days (SE ± 1.6) and 32.4 days (SE ± 1.6). Longer waiting times were also associated with physicians affiliated with universities (P = .001) and certain subspecialties, such as pediatric otolaryngology (P < .001) and neurotology (P = .008). Regional differences were also observed, with specific AAO‐HNS regions showing shorter wait times. The model achieved a conditional R‐squared value of 0.947.ConclusionThis study reveals disparities in wait times for otolaryngology care based on insurance type, with extended wait times for Medicaid beneficiaries. The findings highlight a potential access to care disparity, which begets the need for strategies that ensure equitable access to otolaryngology care and further research to understand the underlying reasons for these potential disparities.

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