OBJECTIVES:

UF are benign neoplasms affecting women of reproductive age. Current American College of Obstetricians and Gynecologists 2021 Guidelines highlight racial disparity patterns and marked differences between Black(B) and White(W) women. Our objective is to describe clinical characteristics, treatment patterns, HCRU and cost in women with UF and HMB in a Commercial database stratified by race.

METHODS:

Using Optum® Socio-Economic Status claims database, a retrospective analysis identified women across 2 cohorts, UF diagnosis first then HMB (UF-HMB) and HMB then UF (HMB-UF), between January 1, 2011-June 30, 2020. Patients required 12 months of continuous enrollment pre- and post- index, with 12 months follow-up. Patients were stratified by race with descriptive statistics comparing Blacks and Whites using Chi-square and t-tests.

RESULTS:

HMB-UF cohort results are similar. Results shown are for UF-HMB cohort. 26,803 (UF-HMB) women were identified (B-30.9%, W-69.1%). Blacks were younger in age [mean (SD): B-41.9 (6.2) vs W-43.8 (6.2); p<0.0001]. Differences in baseline comorbidities were observed: obesity (B-14.7% vs W-9.8%; p<0.0001), hypertension (B-27.2% vs W-16.5%; p<0.0001), anxiety (B -7.7% vs W-13.2%; p<0.0001) and depression (B-7.1% vs W-10.9%; p<0.0001). While the prevalence of bulk symptoms was similar between groups (B-41.8% vs W-42.7%), Blacks received less hormone therapy (B-21.8% vs W-30.9%; p<0.0001). Hysterectomy was the most common gynecological procedure across cohorts; however, fewer Blacks underwent this definitive procedure (B-28.2% vs W-34.1 %; p<0.0001). While Blacks had more Emergency Room visits, [mean (SD): 0.56 (1.35) vs 0.37 (1.12); p<0.0001] and hospitalizations [mean (SD): 0.30 (0.59) vs 0.24 (0.52); p<0.0001], Whites had more outpatient visits. All-cause healthcare costs were less among Blacks (B-$18,614 vs W-$19,883; p<0.0001). Most costs were for outpatient visits (B-$11,735 vs. W-$13,523).

CONCLUSIONS:

While both cohorts had similar burden of disease, baseline comorbidities and HCRU differed. Compared to Whites, Blacks received more acute care services though fewer dollars were spent on their care.