Healthcare Disparities in the Treatment of Pelvic Floor Disorders
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RECONSTRUCTED BLADDER FUNCTION & DYSFUNCTION (M KAUFMAN, SECTION EDITOR)
Healthcare Disparities in the Treatment of Pelvic Floor Disorders Jennifer Nauheim 1 & Elishia McKay 2 & Melissa Laudano 1 & Nitya Abraham 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Pelvic floor disorders (PFD) include urinary incontinence, pelvic organ prolapse, fecal incontinence and other storage and emptying abnormalities. These disorders are common among women and are significantly undertreated. Healthcare disparities may partly explain this phenomenon. Recent Findings Disparities in the treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence can be stratified by race, age, and socioeconomic status. Race is often closely intertwined with socioeconomic status, access to care, and mistrust of healthcare providers. Overall, the etiology of disparities in treatment of PFD is multifactorial and complex. Summary Normalization and removing the stigma of pelvic floor disorders, using better metrics for screening, and increasing the diversity in studies that assess pelvic floor disorders may reduce healthcare disparities in treatment, leading to improved care for common and treatable pelvic floor conditions. Keywords Pelvic floor disorders . Incontinence . Pelvic organ prolapse . Disparities
Introduction Healthcare disparities, as defined by The National Institute of Health, are differences in the incidence, prevalence, mortality, burden of diseases and other adverse health conditions, that exist among specific population groups in the United States
Jennifer Nauheim and Elishia McKay contributed equally to this work and are co-first authors This article is part of the Topical Collection on Reconstructed Bladder Function & Dysfunction * Nitya Abraham [email protected] Jennifer Nauheim [email protected] Elishia McKay [email protected] Melissa Laudano [email protected] 1
Department of Urology, Montefiore Medical Center, 1250 Waters Pl, The Bronx, NY 10461, USA
2
Division of Female Pelvic Medicine, Department of Obstetrics and Gynecology, Montefiore Medical Center, 4170 Bronx Blvd, The Bronx, NY 10467, USA
[1]. These disparities are caused by multiple factors including: racial differences, variances in healthcare access (including specialists), as well as socioeconomic status which is demonstrable in insurance coverage and inability to keep up with rising out of pocket costs. Together these differences may be indicative of an injustice within the healthcare system and highlight potential biases in healthcare providers. In contrast, healthcare dissimilarities are racial or ethnic differences not caused by underlying inequality; they may be secondary to genetic differences, cultural preferences or patient choice [2]. This review will be focusing on disparities, though the difference between dissimilarities and disparities can be nuanced. Pelvic floor disorders include urinary incontinence, pelvic organ prolapse, fecal incontinence and other sto
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