OBJECTIVE To determine unmet need for menopause care in Oregon and evaluate if insurance type is associated with receipt of care. METHODS We conducted a cross-sectional survey of patients using an Oregon Listserv. Our primary outcome was use of medication for the treatment of moderate or severe symptoms of menopause. We used the Menopause Rating Scale to evaluate respondents' symptoms: 0-4 none or little symptoms; 5-8 mild symptoms; 9-16 moderate symptoms; and 17+ severe symptoms. We abstracted demographic and clinical information including age, rurality, race, ethnicity, primary language, and insurance type. We used a regression model to determine the association between public insurance and treatment for moderate to severe menopause symptoms. We examined reasons for nonuse of therapy. RESULTS Our sample included 845 perimenopausal or postmenopausal individuals who were predominantly White (93.0%), aged 45-49 (32.8%) or 50-54 years (39.1%), and privately insured (81.3%). Overall, 62.4% of individuals with moderate and severe symptoms of menopause were not receiving any therapy. After adjustment for age and rurality, public insurance was associated with an average of 47% increased odds of nontreatment for moderate or severe menopause symptoms (adjusted odds ratio: 1.47, 95% CI: 0.99-2.19). The most common reasons for nontreatment in both groups were "therapy was not recommended by a provider" (43%) and worries about safety or side effects (40%). CONCLUSIONS Even in well-insured persons, the majority of people with moderate and severe symptoms of menopause are not receiving treatment. People who are publicly insured are more likely to go untreated than privately insured individuals.

中文翻译：

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保险类型与俄勒冈州未满足的更年期护理需求相关联。


目的 确定俄勒冈州未满足的更年期护理需求，并评估保险类型是否与接受护理相关。方法 我们使用 Oregon Listserv 对患者进行了横断面调查。我们的主要结局是药物治疗中度或重度更年期症状。我们使用更年期评定量表来评估受访者的症状： 0-4 没有或很少症状;5-8 例轻度症状;9-16 种中度症状;和 17+ 严重症状。我们提取了人口统计学和临床信息，包括年龄、农村、种族、民族、主要语言和保险类型。我们使用回归模型来确定公共保险与中度至重度更年期症状治疗之间的关联。我们检查了不使用治疗的原因。结果 我们的样本包括 845 名围绝经期或绝经后个体，他们主要是白人 （93.0%）、年龄在 45-49 岁 （32.8%） 或 50-54 岁 （39.1%） 和私人保险 （81.3%）。总体而言，62.4% 的中度和重度更年期症状个体没有接受任何治疗。在调整年龄和农村后，公共保险与中度或重度更年期症状不治疗的几率平均增加 47% 相关（调整比值比：1.47,95% CI：0.99-2.19）。两组中未治疗的最常见原因是“提供者不推荐治疗”（43%） 和担心安全性或副作用 （40%）。结论即使在保险良好的人中，大多数具有中度和重度更年期症状的人也没有接受治疗。有公共保险的人比有私人保险的人更有可能得不到治疗。