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The following is a summary of “Urinary Incontinence Care in the Academic and Safety-Net Primary Care Settings: Opportunities to Improve Quality of Care,” published in the July 2024 issue of Urology by Burton et al.

This study aims to evaluate and compare the quality of urinary incontinence (UI) care provided to women in safety-net versus non-safety-net primary care settings before their referral to a specialist. Researchers conducted a retrospective review encompassing 200 women from two non-safety-net hospitals and 188 women from two safety-net hospitals referred to Urogynecology and Reconstructive Surgery specialists for bothersome UI between March 2017 and March 2020. 

The analysis focused on assessing the adherence to quality indicators (QIs) within the 12 months preceding referral, including whether essential diagnostic measures such as urinalysis and pelvic examinations were performed. The findings revealed that women from safety-net hospitals received QI-compliant care at a higher rate than those from non-safety-net hospitals, with 55.53% adherence in the safety-net setting compared to 40.3% in the non-safety-net setting (p<0.01). Additionally, clinicians in safety-net hospitals demonstrated greater adherence to QIs across various types of incontinence, including general, stress, and urgency incontinence. This suggests that women in safety-net settings experienced more timely, quality-based UI care before referral. 

Factors contributing to this disparity may include the safety-net system’s implementation of an eConsult referral system, which guides referring clinicians on appropriate pre-specialist management steps, and women’s health-focused primary care clinics within these settings.

Source: sciencedirect.com/science/article/abs/pii/S0090429524005922