Kreisel K, et al. - The trends in diagnoses of acute pelvic inflammatory disease in a nationally representative sample of emergency departments is ascertained in this study. Nationally representative information shows the percent of emergency department visits with a pelvic inflammatory disease diagnosis reduced amid 2006-2013 among females aged 15-44 years, primarily driven by reduced diagnoses of pelvic inflammatory disease among females aged 15-19 years and among women living in the Southern United States. Despite declines, a large number of females of reproductive age are receiving care for pelvic inflammatory disease in emergency departments. Patients with lower median income and no or public health insurance status, which may reduce access to and utilization of healthcare services, consistently had the highest percentage of emergency department visits because of pelvic inflammatory disease. Future research must concentrate on obtaining a better comprehension of variables affecting trends in pelvic inflammatory disease diagnoses and ways to address the challenges surrounding surveillance for this condition.

Methods

• Amid 2006-2013, all emergency department visits among females aged 15-44 years with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code indicating pelvic inflammatory disease were evaluated from the HealthCare Utilization Project Nationwide Emergency Department Sample.
• Total and annual percent changes in the proportion of pelvic inflammatory disease emergency department visits were assessed utilizing trend investigations.

Results

• While the number of emergency department visits among females aged 15-44 years amid 2006-2013 increased (6.5 to 7.4 million), the percent of visits because of pelvic inflammatory disease reduced from 0.57% in 2006 to 0.41% in 2013 (total percent change: -28.1%; annual percent change: -4.3%; 95% CI: -5.7%, -2.9%).
• They observed that the largest decreases were among those aged 15-19 years (total percent change: -40.6%; annual percent change: -6.6%; 95% CI: -8.6%, -4.4%) and living in the South (total percent change: -38.0%; annual percent change: -6.2%; 95% CI: -7.8%, -4.6%).
• Females aged 15-19 years who lived in the South had a 47.9% decrease in visits because of pelvic inflammatory disease (APC: -8.4%, 95% CI: -10.4, -6.5).
• Patients living in zip codes with the lowest median income (<$38,000) had the highest percent of visits with a pelvic inflammatory disease diagnosis; the smallest declines over time were in patients living in zip codes with the highest median income (i.e., >$64,000, total percent change: -24.4%; annual percent change: -3.8%; 95% CI: -5.2%, -2.4%).
• The percent of emergency department visits because of pelvic inflammatory disease was highest among patients not charged for their visit, self-paying, or those covered by Medicaid, with total percent changes in these three groups of -27.8%, -30.7%, and -35.1%, respectively.
• The largest decrease in emergency department visits with a diagnosis of pelvic inflammatory disease was seen in the patients with Medicaid coverage (total percent change: -35.1%; annual percent change: -5.8%; 95% CI: -7.2%, -4.3%).