The database included all 4306 members. Average annual cost per member was $9,280, average age was 35.5 years, and 53% were female. Twenty five percent (25%) of members (1079) had a benign pelvic diagnosis, which increased average cost per member to $18,980.
The most frequent pelvic symptoms were bladder, followed by pelvic pain, musculoskeletal, bowel, and sexual symptoms 46.3%, 23.5%, 21.4%, 11.6%, and 8.4% respectively of those with pelvic symptoms, and 13.7%, 7.0%, 6.4%, 3.4%, and 2.5% of the entire population respectively. Neurologic diagnoses relevant to pelvic health were present in 304 patients (7.1% of the membership) and endometriosis in 70 (1.62%).
Associations of one pelvic symptom were observed with the others. Of the 592 patients with bladder symptoms, 377 (63.7%) had one additional pelvic symptom, 165 (28%) had two, 40 (6.8%) had three, and 10 (1.7%) had four (Chi-square = 285.4, p value < 0.001). Of the 301 patients who had pelvic pain, 139 (46%) had one additional pelvic symptom, 117(39%) two, 36 (12%) had three, and 9 (3%) had four (Chi-square = 285.7, p value < 0.001). Of the 274 patients who had MSK symptoms, 165 (60%) had one additional pelvic symptom, 64 (24%) had two, 35 (12.8%) had three, and 10 (3.7%) had four (Chi-square = 183.6, p value < 0.001). Of the 148 patients who had bowel symptoms, 80 (54%) had one additional pelvic symptom, 46 (31%) had two, 15 (10.1%) had three, and 7 (4.7%) had four (Chi-square = 100, p value < 0.001). Of the 304 patients who had neurological symptoms relevant to the pelvis, 91 (30%) had one pelvic symptom, 42 (14%) had two, 6 (2%) had three, and 3 (1%) had four additional pelvic symptoms (Chi-square = 432, p value < 0.001). Endometriosis did not have a significant relationship.
In those with bladder diagnoses, 6.7% had bowel diagnoses (Chi-square = 24.9, p value < 0.001), 11.8% had MSK diagnoses (Chi-square = 60.1, p value < 0.001), 18.4% had pelvic pain (Chi-square = 16.0, p = < 0.001), 14.2% had neurological diagnoses (Chi-square = 55.6, p value < 0.001), and 3.7% had endometriosis ( Chi-Square 6.5, p = 0.01). In those with bowel diagnoses, 4% had sexual symptoms (Chi-square = 4.1, p value = 0.04), 14.9% had MSK diagnoses (Chi-square = 4.3, p value = 0.039), and 13.5% had neurological diagnoses (Chi-square = 9.7, p value < 0.001). In those with sexual diagnoses 5% had pelvic pain (Chi-square=6.08, p value=0.014), 5.6% had endometriosis (Chi-square = 0.002, p value=0.967), 8.3% had MSK diagnoses (Chi-square = 12.0, p value=0.001), and 6.3% had neurological diagnoses (Chi-square= 2.47, p value=0.116). In those with pelvic pain, 13% had neurological diagnoses (Chi-square = 25.3, p value < 0.001, 5% had sexual diagnoses (Chi-square = 6.1, p value = 0.014), 9.6% had endometriosis (Chi-square = 13.2, p value <0.001). In those with MSK diagnoses, 15.7% had neurological diagnoses (Chi-square = 12.5, p value <0.001). 8% of patients with MSK symptoms had endometriosis (Chi-square = 4.4, p value = 0.04). 3% of patients with neurological diagnoses reported endometriosis (Chi-square = 4.9, p value = 0.028) (Table 1).
The annual healthcare cost for members was an average of $9,280 per member. Patients with only a neurological diagnosis or endometriosis without other pelvic diagnoses had mean annual expenditure of $19,767 (SD±$42,496 (n=201), For those with one pelvic symptom classes, the mean annual cost was $14,784 (SD±$44,554 (n=800)); for two pelvic symptom classes $25,455 (SD±$49,143 (n=224)); for three $44,003 (SD± $79,293 (n=45)) for four $96,959 (SD±$134,896 (n=10)). F value = 12.3, p value < 0.001 (Figure 1).