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Responding to Women’s Gynecological Health Needs

Photos of women's health examinations

Why It Matters

Complex gynecological issues are diagnosed and managed through a team-based approach that includes comprehensive and individualized care plans.

Women with vulvar disorders, chronic pelvic pain and pelvic floor disorders (urinary and anal incontinence and pelvic organ prolapse) have their concerns addressed and adequately treated, regardless of ability to pay, improving their overall health and well-being.

Defining the Problem

A recent claims analysis reveals that an estimated 300,000 women in the Austin area live with complex gynecologic conditions such as pelvic floor disorders, chronic pelvic pain and vulvar disorders. About 1 in 5 women experience pelvic floor problems, disorders that lead to conditions such as urinary incontinence. Yet an estimated 50 percent of women who experience urinary incontinence don’t seek treatment because of the embarrassing nature of the symptoms, belief that the condition is unavoidable due to age and lack of understanding about the availability of effective treatment.

Nearly 1 in 10 women experience chronic pelvic pain. Of women with chronic pelvic pain, only about 61 percent will receive a diagnosis and of those, only 7 in 10 will receive the correct diagnosis and treatment. It isn’t uncommon for women with untreated pelvic pain go on to develop chronic pelvic pain syndrome. This can lead to depression, increased proportional pain and challenging effects to intimate and interpersonal relationships.

Women also experience vulvar disorders such as vulvodynia — chronic pain affecting the vulva, the external part of the female genitalia — and vulvar dermatoses — skin disorders that affect the vulva. Vulvodynia is commonly undiagnosed. A study showed that 6 in 10 women who visited three or more doctors for the condition received no diagnosis at all. Delayed diagnosis can lead to decreased sexual function in women and lower overall quality of life.

PERCENTAGE OF WOMEN RECEIVING TREATMENT

Few Get the Treatment They Need

An estimated 142,000 women in the Austin area are living with pelvic floor disorders.

Claims data shows that fewer than 9,500 of them have received treatment.

What Dell Med Is Doing

To address this gap in care for women in the greater Travis County area, Dell Med’s Department of Women’s Health is redesigning how women access and obtain care for complex gynecological conditions.

The team is focused on accurately identifying the condition and its causes and using a collaborative, team-based model to develop a comprehensive treatment plan with appropriate support services.

Because these complex gynecologic issues often overlap and patients present with comprehensive concerns that can include emotional health, relationship challenges and other issues that can affect treatment outcomes, the team includes both specialists and support services. They include gynecology, social work, psychiatry, dermatology, urogynecology and pelvic floor physical therapy, and nutrition. The team collects baseline patient-reported outcome measures through questionnaires to assess severity of the condition, quality of life, home and family environment, participation in healthy behaviors and more. It then reassesses to measure progress and effectiveness of treatment.

This approach allows women to access comprehensive physical, mental and social support care in one visit and space — without the need for referrals or traveling to multiple locations — which benefits the efficacy of the treatment plan, compliance with treatment and positive health care outcomes.

Women receive this care at the Women’s Health Institute, part of UT Health Austin — the clinical practice of Dell Med — which provides access to high-quality care for all patients.

Graphic image of dollar signs

The Cost Is Huge

Medical costs and loss of productivity associated with chronic pelvic pain alone are estimated at $2.8 billion and $15 billion per year.

Summary

Through the Women’s Health Institute, complex gynecologic care is now available for all women in need of subspecialty care and treatment in the Austin area, regardless of their ability to pay.