Title

Impact of Race, Gender, and Socioeconomic Status on Symptom Severity at Time of Urologic Referral.

Authors

Joan S Ko
Christopher Corbett, Children's Hospital of Philadelphia, Philadelphia, PA
Katherine M Fischer, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Amanda Berry, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Dana A Weiss, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Christopher J Long, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Stephen A Zderic, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Jason P Van Batavia, Children's Hospital of Philadelphia, Philadelphia, PAFollow

Publication Title

J Racial Ethn Health Disparities

Document Type

Article

PubMed ID

35960437

Abstract

BACKGROUND AND OBJECTIVES: The Dysfunctional Voiding and Incontinence Scoring System (DVISS) is a validated tool to evaluate lower urinary tract dysfunction (LUTD) severity in children. DVISS provides a quantitative score (0-35) including a quality-of-life measure, with higher values indicating more/worse symptoms. Clinically, variability exists in symptom severity when patients present to pediatric urology with LUTD. We hypothesized that symptom severity at consultation varied based on race, gender, and/or socioeconomic status.

METHODS: All urology encounters at a single institution with completed modified DVISS scores 6/2015-3/2018 were reviewed. Initial visits for patients 5-21 years old with non-neurogenic LUTD were included. Patients with neurologic disorders or genitourinary tract anomalies were excluded. Wilcoxon rank sum tests compared scores between White and Black patients and between male and female patients. Multiple regression models examined relationships among race, gender, estimated median household income, and insurance payor type. All statistics were performed using Stata 15.

RESULTS: In total, 4086 initial patient visits for non-neurogenic LUTD were identified. Median DVISS scores were higher in Black (10) versus White (8) patients (p < 0.001). Symptom severity was higher in females (9) versus males (8) (p < 0.001). When estimated median income and insurance payer types were introduced into a multiple regression model, race, gender, and insurance payer type were significantly associated with symptom severity at presentation.

CONCLUSIONS: Race, gender, and socioeconomic status significantly impact LUTS severity at the time of urologic consultation. Future studies are needed to clarify the etiologies of these disparities and to determine their clinical significance.

Keywords

Lower Urinary Tract Dysfunction, Racial Disparities, Socioeconmic Disparities, Pediatric Urology, Gender Disparities, Dysfunctional Voiding

DOI

10.1007/s40615-022-01357-9

Publication Date

8-12-2022

Citation

Ko, J., Corbett, C., Fischer, K., Berry, A., Weiss, D., Long, C., Zderic, S., & Van Batavia, J. (2022). Impact of Race, Gender, and Socioeconomic Status on Symptom Severity at Time of Urologic Referral.. J Racial Ethn Health Disparities https://doi.org/10.1007/s40615-022-01357-9