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The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System

BACKGROUND: PCOS is a prevalent endocrine and metabolic disorder in women characterized by abnormal blood glucose, dyslipidemia, and abnormal mental health. To improve patient care, the goal of our study is to find out if there are differences in how PCOS patients are treated at different hospital l...

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Autores principales: Wang, Yue, Chen, Jie, Dong, Han, Ma, Ruilin, Zou, Ying, Wang, Wei, Zheng, Qingmei, Feng, Ying, Tan, Zhangyun, Zeng, Xiaoqin, Zhao, Yinqing, Deng, Yan, Wang, Yanfang, Gu, Bei, Sun, Aijun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499778/
https://www.ncbi.nlm.nih.gov/pubmed/36158894
http://dx.doi.org/10.1155/2022/9778678
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author Wang, Yue
Chen, Jie
Dong, Han
Ma, Ruilin
Zou, Ying
Wang, Wei
Zheng, Qingmei
Feng, Ying
Tan, Zhangyun
Zeng, Xiaoqin
Zhao, Yinqing
Deng, Yan
Wang, Yanfang
Gu, Bei
Sun, Aijun
author_facet Wang, Yue
Chen, Jie
Dong, Han
Ma, Ruilin
Zou, Ying
Wang, Wei
Zheng, Qingmei
Feng, Ying
Tan, Zhangyun
Zeng, Xiaoqin
Zhao, Yinqing
Deng, Yan
Wang, Yanfang
Gu, Bei
Sun, Aijun
author_sort Wang, Yue
collection PubMed
description BACKGROUND: PCOS is a prevalent endocrine and metabolic disorder in women characterized by abnormal blood glucose, dyslipidemia, and abnormal mental health. To improve patient care, the goal of our study is to find out if there are differences in how PCOS patients are treated at different hospital levels within the hierarchical medical system. METHODS: Obstetricians and gynecologists from primary, secondary, and tertiary hospitals were the participants in the survey. The responses provided and collected were analyzed using various statistical techniques like the chi-square test, Fisher exact test, and logistic regression with multiple variables. RESULTS: The investigation examined 2298 survey replies (13.1% primary hospitals, 52.4% secondary hospitals, and 34.5% tertiary hospitals). As hospital grade increases, more participants inquire about a patient's history of unfavorable pregnancies concerning hormone evaluation; the better the hospital's grade, the greater the number of participants who would undergo AMH and androgen-related tests. The higher the hospital level, the more participants would pick the oral glucose tolerance test (OGTT) to determine insulin resistance, the BMI Asian criteria for defining obesity, and blood lipids. Participants in primary (odds ratio (OR) = 0.383, 95% confidence interval (CI) 0.282-0.520) and secondary (OR = 0.607, 95% confidence interval (CI) 0.481-0.765) hospitals were significantly less likely to select OGTT than those in tertiary hospitals. Comparatively, fewer primary hospitals chose to do lipid profiling than tertiary hospitals (OR 0.689, 95% CI 0.523-0.909). With the increase in hospital level, participants were more knowledgeable about the multiple efficacies and dose alternatives of metformin and selected letrozole and assisted reproduction more frequently. CONCLUSION: Our study uncovered differences in the endocrine evaluation, metabolic screening, and management of PCOS patients across obstetrics and gynecology at various hospital levels. Simultaneously, it underlines the need to improve the hierarchical medical system and close the knowledge gap across hospitals.
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spelling pubmed-94997782022-09-23 The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System Wang, Yue Chen, Jie Dong, Han Ma, Ruilin Zou, Ying Wang, Wei Zheng, Qingmei Feng, Ying Tan, Zhangyun Zeng, Xiaoqin Zhao, Yinqing Deng, Yan Wang, Yanfang Gu, Bei Sun, Aijun Biomed Res Int Research Article BACKGROUND: PCOS is a prevalent endocrine and metabolic disorder in women characterized by abnormal blood glucose, dyslipidemia, and abnormal mental health. To improve patient care, the goal of our study is to find out if there are differences in how PCOS patients are treated at different hospital levels within the hierarchical medical system. METHODS: Obstetricians and gynecologists from primary, secondary, and tertiary hospitals were the participants in the survey. The responses provided and collected were analyzed using various statistical techniques like the chi-square test, Fisher exact test, and logistic regression with multiple variables. RESULTS: The investigation examined 2298 survey replies (13.1% primary hospitals, 52.4% secondary hospitals, and 34.5% tertiary hospitals). As hospital grade increases, more participants inquire about a patient's history of unfavorable pregnancies concerning hormone evaluation; the better the hospital's grade, the greater the number of participants who would undergo AMH and androgen-related tests. The higher the hospital level, the more participants would pick the oral glucose tolerance test (OGTT) to determine insulin resistance, the BMI Asian criteria for defining obesity, and blood lipids. Participants in primary (odds ratio (OR) = 0.383, 95% confidence interval (CI) 0.282-0.520) and secondary (OR = 0.607, 95% confidence interval (CI) 0.481-0.765) hospitals were significantly less likely to select OGTT than those in tertiary hospitals. Comparatively, fewer primary hospitals chose to do lipid profiling than tertiary hospitals (OR 0.689, 95% CI 0.523-0.909). With the increase in hospital level, participants were more knowledgeable about the multiple efficacies and dose alternatives of metformin and selected letrozole and assisted reproduction more frequently. CONCLUSION: Our study uncovered differences in the endocrine evaluation, metabolic screening, and management of PCOS patients across obstetrics and gynecology at various hospital levels. Simultaneously, it underlines the need to improve the hierarchical medical system and close the knowledge gap across hospitals. Hindawi 2022-09-15 /pmc/articles/PMC9499778/ /pubmed/36158894 http://dx.doi.org/10.1155/2022/9778678 Text en Copyright © 2022 Yue Wang et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wang, Yue
Chen, Jie
Dong, Han
Ma, Ruilin
Zou, Ying
Wang, Wei
Zheng, Qingmei
Feng, Ying
Tan, Zhangyun
Zeng, Xiaoqin
Zhao, Yinqing
Deng, Yan
Wang, Yanfang
Gu, Bei
Sun, Aijun
The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System
title The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System
title_full The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System
title_fullStr The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System
title_full_unstemmed The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System
title_short The Disparity in the Management of Polycystic Ovary Syndrome between Obstetrician-Gynecologists in Different-Level Hospitals under the Hierarchical Medical System
title_sort disparity in the management of polycystic ovary syndrome between obstetrician-gynecologists in different-level hospitals under the hierarchical medical system
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499778/
https://www.ncbi.nlm.nih.gov/pubmed/36158894
http://dx.doi.org/10.1155/2022/9778678
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