TY - JOUR
AU - E. F. Zaritsky
AU - L . Y. Tucker
AU - E. Hen
AU - A. J. Childs
AU - M. L. Ritterman Weintraub
AU - C. Wicks
A1 - 
AB - OBJECTIVE: To assess disparities in medical and surgical management of endometriosis and pelvic pain disorders, focusing on Black individuals and individuals from other racial and ethnic groups within an integrated health care delivery system. METHODS: We conducted a retrospective cohort study of women aged 18 years or older with a pelvic pain disorder, including endometriosis, pelvic pain, dysmenorrhea, and dyspareunia, coded in the electronic health record (EHR) between 2012 and 2019 within Kaiser Permanente Northern California. Demographic, clinical, and treatment characteristics were assessed overall and by patient race and Black compared with other racial and ethnic groups as coded in the EHR. RESULTS: Of 15,164 eligible women, 1,707 (11.3%) were Black and 13,457 (88.7%) were non-Black, including 44.4% White patients, 13.8% Asian patients, 24.8% Hispanic patients, and 5.7% patients from other or unknown racial and ethnic groups. Black compared with non-Black women were younger (median [interquartile range] age 36 years [28-44 years] vs 37 years [30-45 years], P<.001), had a higher median [interquartile range] body mass index (BMI) (29.8 [25.2-35.9] vs 26.0 [22.7-30.7], P<.001), and had similar parity. Compared with non-Black women, a higher proportion of Black women received hormonal therapy (56.2% vs 51.9%, P=.001), pain medications (55.4% vs 44.7%, P=.001), and surgery (25.5% vs 23.0%, P=.02). A smaller proportion of all non-White women were referred to a pelvic pain physician specialist compared with White women (P=.001), with Black women referred at lower rates (14.9% vs 18.4%, P=.001). CONCLUSION: Black women in this integrated health care system received more hormonal, pain, and surgical management for endometriosis than non-Black women. However, there was a lower referral rate to pelvic pain physician specialists among all non-White women compared with White women, which highlights the need to better understand care allocation.
AD - Department of Obstetrics and Gynecology and the Department of Graduate Medical Education, Kaiser Permanente East Bay, Oakland, and the Division of Research, Kaiser Permanente Northern California, Pleasanton, California.
AN - 40839882
BT - Obstet Gynecol
C5 - Healthcare Disparities
DA - Aug 21
DO - 10.1097/aog.0000000000006045
DP - NLM
ET - 20250821
JF - Obstet Gynecol
LA - eng
N2 - OBJECTIVE: To assess disparities in medical and surgical management of endometriosis and pelvic pain disorders, focusing on Black individuals and individuals from other racial and ethnic groups within an integrated health care delivery system. METHODS: We conducted a retrospective cohort study of women aged 18 years or older with a pelvic pain disorder, including endometriosis, pelvic pain, dysmenorrhea, and dyspareunia, coded in the electronic health record (EHR) between 2012 and 2019 within Kaiser Permanente Northern California. Demographic, clinical, and treatment characteristics were assessed overall and by patient race and Black compared with other racial and ethnic groups as coded in the EHR. RESULTS: Of 15,164 eligible women, 1,707 (11.3%) were Black and 13,457 (88.7%) were non-Black, including 44.4% White patients, 13.8% Asian patients, 24.8% Hispanic patients, and 5.7% patients from other or unknown racial and ethnic groups. Black compared with non-Black women were younger (median [interquartile range] age 36 years [28-44 years] vs 37 years [30-45 years], P<.001), had a higher median [interquartile range] body mass index (BMI) (29.8 [25.2-35.9] vs 26.0 [22.7-30.7], P<.001), and had similar parity. Compared with non-Black women, a higher proportion of Black women received hormonal therapy (56.2% vs 51.9%, P=.001), pain medications (55.4% vs 44.7%, P=.001), and surgery (25.5% vs 23.0%, P=.02). A smaller proportion of all non-White women were referred to a pelvic pain physician specialist compared with White women (P=.001), with Black women referred at lower rates (14.9% vs 18.4%, P=.001). CONCLUSION: Black women in this integrated health care system received more hormonal, pain, and surgical management for endometriosis than non-Black women. However, there was a lower referral rate to pelvic pain physician specialists among all non-White women compared with White women, which highlights the need to better understand care allocation.
PY - 2025
SN - 0029-7844
ST - Racial Disparities in Endometriosis and Pelvic Pain Treatment Within an Integrated Health Care Delivery System
T1 - Racial Disparities in Endometriosis and Pelvic Pain Treatment Within an Integrated Health Care Delivery System
T2 - Obstet Gynecol
TI - Racial Disparities in Endometriosis and Pelvic Pain Treatment Within an Integrated Health Care Delivery System
U1 - Healthcare Disparities
U3 - 10.1097/aog.0000000000006045
VO - 0029-7844
Y1 - 2025
ER -