Podium Session

Poster, Podium & Video Sessions

PD06-09: Healthcare Disparities: Do Medicaid patients have longer wait times for outpatient urological evaluation?

Friday, May 12
10:50 AM - 11:00 AM
Location: BCEC: Room 161

Presentation Authors: Wai Lee*, Andrew Chen, Ramsey Al-Khalil, Tal Cohen, William T. Berg, Wayne C. Waltzer, Jason Kim, Howard L. Adler, Stony Brook, NY

Introduction: Insurance status has been demonstrated to be a barrier to prompt urological care. Telephone surveys reveal that substantially fewer urologists accept Medicaid compared to Medicare or private insurance. There is a paucity of urologic literature evaluating discrepancies in wait times for Medicaid patients versus other forms of insurance. We sought to evaluate wait time disparities in academic urology programs for Medicaid compared to Medicare patients.

Methods: The cohort was identified from the online listing of all ACGME accredited urology residency programs. An IRB-approved standardized script was used to contact each institution to determine if they accepted Medicaid patients. For institutions that accepted Medicaid, separate calls were made to establish the earliest appointment time available for a fictional patient with Medicaid and then Medicare insurance. Discrepancies in wait times between insurance type were compared. All statistical analysis was performed using SPSS v24.0.

Results: All 131 ACGME accredited academic urology programs were surveyed. Of these, 10 (7.6%) did not accept new patients with Medicaid insurance. 13 institutions (9.92%) declined to participate in our study. There were 108 academic urology clinics in our final analysis. Of these, 59% (n=64) had longer wait times for Medicaid patients. Overall, there was a significant difference (p<0.001) between the mean wait times for a new patient visit with Medicare (23 days, STD 20.8) versus Medicaid (35 days, STD 27.5). For Medicaid appointments, 73.1% (n=79) were scheduled in resident run clinics only. When stratified by AUA section, academic urology programs had longer average wait times for Medicaid patients when compared to Medicare patients. However, only the New York (n=16, 26.8 vs 10.1 days, p=0.022) and Southeastern (n=23, 41.8 vs 26.8 days, p=0.050) sections had significantly longer wait times (Table 1).

Conclusions: Our data suggests that patients with Medicaid experience longer wait times for their initial urological evaluation. Barriers to timely clinical evaluation have been cited as a reason for emergency room visitation. Awareness of such disparities in urologic care is an early step toward improving the quality of healthcare for all individuals.

Source Of Funding: none

Wai Lee, MD

Stony Brook Medicine

Wai Lee is a PGY5 (out of 6 year) urology resident at Stony Brook. He grew up in NYC and went to medical school at Stony Brook School of Medicine. His plan is to pursue a fellowship in Female Pelvic Medicine & Reconstructive Surgery. His research interests include socioeconomics, surgical videos, neuromodulation and outcomes research. He has been a member of the AUA since 2012.

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