Determinants of Health Care Dissatisfaction Among a US Population-Based Cohort of Women With Polycystic Ovary Syndrome

Abstract

Abstract Context The 2018 International Evidence-Based Guidelines (IEBG) for polycystic ovary syndrome (PCOS) were created, in part, in response to poor patient satisfaction on international surveys. Patient satisfaction in the United States before and after these guidelines has not yet been characterized. Objective To evaluate care patterns and patient attitudes among US women with PCOS before and after IEBG. Methods This was a cross-sectional study of a population-based community sample of US women with confirmed PCOS who completed standardized questionnaires on care patterns and satisfaction in care. Results Among 1056 respondents, aged 23 ± 6 years at diagnosis, 69.2% had to wait ≥ 1 year and 72.9% saw > 1 provider prior to receiving a diagnosis. Less than 45% strongly agreed or agreed with statements regarding trusting their doctor and < 27% were very or somewhat satisfied with care across all questions. In multivariable analyses, composite outcome of trusting your physician was associated with insurance type (uninsured vs private) (odds ratio [95% CI] 0.5 [0.3-0.9], P = .020), race (Hispanic vs Caucasian) (0.6 [0.5-0.9], P = .007), (Black vs Caucasian) (1.6 [1.0-2.4], P = .045) and timing of diagnosis (within 5 years vs > 5 years) (1.3 [1.0-1.7], P = .038). Care satisfaction was associated with insurance type (public vs private) (0.6 [0.4-0.9], P = .010), (uninsured vs private) (0.5 [0.3-0.9], P = .021), and timing of diagnosis (within 5 years vs > 5 years) (1.4 [1.1-1.9], P = .010). Conclusion Satisfaction and trust in care is overall poor among US patients with PCOS. Higher scores among those diagnosed within the past 5 years, compared to those with a more remote diagnosis, may indicate an improving trend in care.