Studies from Cleveland Clinic Update Current Data on Managed Care (Unequal Utilization of Overactive Bladder Treatment: The Role of Socioeconomic and Insurance Disparities): Managed Care

2026 JUN 29 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators discuss new findings in Managed Care. According to news reporting originating from Cleveland, Ohio, by NewsRx correspondents, research stated, “To evaluate the association between neighborhood-level socioeconomic disadvantage (SED) and insurance type with pharmacologic and procedural treatment patterns in the management of overactive bladder (OAB). We conducted a retrospective cohort study of patients diagnosed with OAB at a tertiary academic medical center between 2011 and 2023.”

Our news editors obtained a quote from the research from Cleveland Clinic, “Variables included receipt of pharmacotherapy, and minimally invasive therapy (MIT), corresponding to guideline-defined procedural interventions for OAB, such as sacral neuromodulation (SNM), posterior tibial nerve stimulation (PTNS), and intravesical botulinum toxin (BTX). Neighborhood-level SED was measured using the area deprivation index (ADI), with patients stratified by national ADI quartile. Higher ADI scores indicate greater SED. Insurance type was recorded. Among 6786 patients included in the study, higher ADI (greater SED) was associated with increased anticholinergic use and decreased b3-agonist use (p < 0.0001). Privately insured patients were less likely to receive therapy than Medicare patients, while Medicare patients experienced the longest delay to MIT (93.6 vs. 89.9 vs. 73.0 months, respectively; p = 0.002). On multivariable analysis, ADI and insurance status independently predicted OAB treatment. Higher rates of BTX were observed among Medicare patients compared with Medicaid and private insurance (17.8% vs. 11.9% vs. 10.4%, p< 0.0001), while lower rates of SNM were observed among Black patients (5.9% vs. 11.4%, p< 0.0001). Socioeconomic and insurance disparities influence pharmacologic treatment of OAB, while procedural disparities are more strongly associated with insurance status and race.”

According to the news editors, the research concluded: “Using ADI as a validated measure of neighborhood-level SED, we found that patients from more disadvantaged areas were more likely to receive anticholinergic therapy and less likely to be prescribed b3-agonists.”

This research has been peer-reviewed.

For more information on this research see: Unequal Utilization of Overactive Bladder Treatment: The Role of Socioeconomic and Insurance Disparities. Neurourology and Urodynamics, 2026. Neurourology and Urodynamics can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Neurourology and Urodynamics - http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1520-6777)

The news editors report that additional information may be obtained by contacting Tyler Trump, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, United States. Additional authors for this research include Omer Anis, Jacob M. Knorr and Howard B. Goldman.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1002/nau.70343. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Neurourology and Urodynamics is: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.

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