Health Seeking Behaviors and Healthcare Utilization in Women Diagnosed with Endometriosis: A Systematic Review

  • Dr Jia Chen (MD) Mater Hospital, Brisbane Australia, Mater Hospital
  • Yuyang Liu University of Queensland, Faculty of Medicine
  • Dr Keisuke Tanaka (MD)
  • Dr Akwasi Amoako (MD) Department of Obstetrics and Gynaecology, Royal Brisbane and Women's Hospital
Keywords: Endometriosis; Infertility; Pelvic Pain; Medical Burden; Seek Medical Care; Healthcare; Chronic Inflammatory Diseases


Introduction: Endometriosis is a chronic inflammatory condition affecting women of childbearing age worldwide. There are limited roles of medical or surgical treatments. Endometriosis not only affects quality of life but also results in significantly increased healthcare service utilization. The review aims to examine the existing literature to gain a comprehensive understanding of healthcare resource utilization in endometriosis patients across different countries. Methods: The systematic review was conducted to include studies on healthcare utilization among endometriosis patients from January 2000 to 2023. The search was conducted in Medline and Embase databases. Search terms related to endometriosis and healthcare resource utilization were used. Studies published in English with data on healthcare utilization across inpatient, outpatient, emergency care, and other services (such as specialist and primary care physician) were included. The studies only examined the cost- or cost-effective analysis were excluded. Results: Women with endometriosis experience a higher prevalence of gynecological and abdominal pain-related conditions, along with a greater burden of comorbidities and infertility issues. They also exhibit significantly higher healthcare utilization across various healthcare settings, including emergency care, inpatient visits, outpatient visits, and specialist care. These utilization differences remain significant up to one year before the diagnosis and persist for at least five years following the diagnosis, with the highest disparity observed in the first year after diagnosis. Conclusion: The systematic review examines the health-seeking behavior and healthcare utilization patterns among women diagnosed with endometriosis across different countries. The findings indicate that women with endometriosis experience a higher burden of medical comorbidities and exhibit increased rates of emergency care visits, inpatient visits, and outpatient visits.


Rowlands IJ, et al. "Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study." BJOG: An International Journal of Obstetrics & Gynaecology 128.4 (2021): 657-665.

Cea Soriano, Lucia, et al. "Incidence, treatment and recurrence of endometriosis in a UK-based population analysis using data from The Health Improvement Network and the Hospital Episode Statistics database." The European Journal of Contraception & Reproductive Health Care 22.5 (2017): 334-343.

Grundström, Hanna, et al. "Healthcare consumption and cost estimates concerning Swedish women with endometriosis." Gynecologic and obstetric investigation 85.3 (2020): 237-244.

Simoens, Steven, et al. "The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres." Human Reproduction 27.5 (2012): 1292-1299.

Eisenberg, Vered H., et al. "Burden of endometriosis: infertility, comorbidities, and healthcare resource utilization." Journal of Clinical Medicine 11.4 (2022): 1133.

Soliman, Ahmed M., et al. "Real-world evaluation of direct and indirect economic burden among endometriosis patients in the United States." Advances in therapy 35 (2018): 408-423.

Fuldeore, Mahesh, et al. "Healthcare utilization and costs in women diagnosed with endometriosis before and after diagnosis: a longitudinal analysis of claims databases." Fertility and sterility 103.1 (2015): 163-171.

Soliman, Ahmed M., et al. "Health care utilization and costs associated with endometriosis among women with medicaid insurance." Journal of managed care & specialty pharmacy25.5 (2019): 566-572.

Surrey, Eric, et al. "Impact of endometriosis diagnostic delays on healthcare resource utilization and costs." Advances in Therapy 37 (2020): 1087-1099.

Original Research Article