The objective of this research is to describe the trends in the emergency department (ED) visits for women with a primary diagnosis of leiomyomas, subsequent hospitalizations, and related expenses in the United States.
The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database were used to identify all ED visits from 2006 to 2017 among women aged 18–55 years with a primary diagnosis of leiomyomas as determined by ICD diagnostic codes. The trends in ED visits and subsequent hospitalizations were examined and stratified according to the patient and hospital variables. Secondary ICD codes, Current Procedural Terminology codes, and hospital costs were also investigated. To determine determinants of admission, a multivariate regression model was applied.
Despite a rise in the number of ED visits for leiomyomas from 28,732 in 2006 to 65,685 in 2017, the admission rate fell from 23.9% in 2006 to 11.1% in 2017. Women aged 36–45 (44.5%), in the lowest income quartile (36.1%), privately insured (38.3%), and living in the South (46.2%) had the largest number of emergency department visits for leiomyomas (odds ratio [OR] 1.23, 95% CI 1.08–1.39) . Nonteaching hospitals or those in the Northeast were more likely to admit patients(OR 1.39, 95% CI 1.15–1.68). Patients with older ages (26–35 years: OR 1.42, 95% CI 1.21–1.66; 36–45 years: OR 2.01, 95% CI 1.72–2.34; 46–55 years: OR 2.60, 95% CI 2.23–3.03) and bleeding-related symptoms (OR 14.92, 95% CI 14.00–15.90) were more likely to be admitted. Uninsured patients were the least likely to be admitted (Medicare: OR 1.37, 95% CI 1.21–1.54; Medicaid: OR 1.26, 95% CI 1.16–1.36; private: OR 1.44, 95% CI 1.32–1.56).
Even though the number of ED visits for leiomyomas is growing, the number of admissions for these visits is decreasing. The significant drop in admissions indicates that many of these visits may be handled in a non–acute-care setting. Women with leiomyomas who present with a bleeding-related complaint, on the other hand, have a 15-fold increased chance of being admitted. There appears to be a variation in the chance of admission based on the type of insurance.
