Discrepancies in Access to Minimally Invasive Gynecologic Surgery Care Between Privately and Publicly Insured Patients

Abstract

Objective:

The goal of this research was to characterize the discrepancy in access to care between publicly and privately insured patients when seeking subspecialty minimally invasive gynecologic surgery services.

Materials and Methods:

In an anonymous cross-sectional survey, patient-related characteristics, commute, and personal logistics–related topics concerning each patient's current appointment were collected from women presenting for care at a single minimally invasive gynecologic surgery clinic of an urban tertiary-care center. A χ² test was used to test the association between dichotomous variables and insurance type between publicly and privately insured patients. A multivariable logistic-regression model was used to calculate the independent associations between the reported burdens and the 2 groups, adjusting for demographic variables. Adjusted odds ratios and their 95% confidence intervals were reported.

Results:

Among the patients, 450 surveys were distributed, with a response rate of 94%. It was noted that 229 patients (54.1%) were privately insured and 194 (45.9%) patients were publicly insured. Finding time to miss work was the most commonly cited barrier by patients. Transportation to the office visit was a significantly larger barrier for public-insurance holders, whereas cost of the visit was more likely to be a barrier to care for patients with private insurance, compared to those patients with public insurance.

Conclusions:

After adjusting for several covariates, transportation was a significant and independent discrepancy in access to care between publicly and privately insured women. This article sheds light on the gap between the 2 groups to be addressed in future studies.