Jacky Chu
MD Student with Scholarly Concentration in Health Services & Policy Research / Surgery, expected graduation Winter 2026
All Publications
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Effectiveness of an Online Health Education Program for Pediatric Lower Urinary Tract Symptoms.
Urology
2025
Abstract
Urotherapy effectively treats pediatric lower urinary tract symptoms, but its delivery is limited in clinical settings. We examined the feasibility and effectiveness of Bladder Basics, a home-based, self-paced online bladder health education program, in improving symptoms and knowledge.Children aged 5 - 10 years with bladder symptoms and their parents were recruited. All participants completed Bladder Basics over four weeks, with outcomes measured at baseline, 4 weeks, and 12 weeks. Feasibility was evaluated through recruitment, engagement, and post-assessment completion. Secondary outcomes included dysfunctional voiding symptom scores, parents' subjective improvement, care-seeking interest, bladder health knowledge, and self-efficacy. Analyses included paired t-tests, Wilcoxon tests, sign tests, and McNemar's tests.Of 70 families, 72% completed the program, 73% completed the 4-week survey, and 67% completed the 12-week survey. Symptom scores improved significantly: 32% at 4 weeks and 42% at 12 weeks. Of children initially screening positive for bladder symptoms, 39% fell below the cutoff score at 4 weeks and 55% at 12 weeks. 85% and 93% of parents reported child symptom improvements at 4 and 12 weeks. Parents reporting no need for clinic visits increased from 45% to 69% at 4 weeks. Knowledge of key urotherapy concepts was improved, such as peeing every 3 hours and bowel health awareness. Self-efficacy improved significantly, with a median increase of 4.6 points at 4 weeks (p = 0.018).Bladder Basics improved bladder symptoms and knowledge and demonstrated potential for broader scalability with strong participant interest and high engagement.NCT05852353.
View details for DOI 10.1016/j.urology.2025.05.058
View details for PubMedID 40456454
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Utilization and Cost of Gender-affirming Surgery in the United States from 2012-2019.
Annals of surgery
2024
Abstract
To characterize the trends in and characteristics associated with the utilization and cost of gender-affirming surgery (GAS) in the United States from 2012-2019.GAS is one option among gender-diverse (GD) people to transition from their biologic anatomy to the anatomy congruent with their gender. Little is known about its utilization and cost trends and whether patient and hospital characteristics are associated with differences in utilization and cost.This serial cross-sectional study collected retrospective data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), a representative pool of inpatient visits in the United States. Records from 2012-2019 that indicated ages 18 or older, GD diagnoses, and GAS procedures were identified using the International Classification of Diseases, Ninth and Tenth Revisions. Within this cohort, demographics, utilization, and cost were collected and analyzed using descriptive statistics and multivariable regression models.6,325 records with GD diagnoses and GAS procedures were identified. From 2012-2019, utilization increased by more than 5-fold (0.9 to 5.0 per 100,000 records among all records), and the mean, inflation-adjusted cost increased by 36% ($19,451 to $26,517). This cost trend was similar by type of surgery, and genital surgery had consistently higher costs than chest surgery from 2012 to 2019 (genital: $21,487 to $26,712, chest: $13,238 to $21,309). Lower odds of utilization were found in records with Medicaid (OR = 0.27, 95% CI [0.22-0.35], P<0.001) and Medicare (OR = 0.15, 95% CI [0.11-0.23], P<0.001) compared to private insurance, as well as those in the lowest income quartile (OR = 0.68, 95% CI [0.54-0.85], P<0.001) compared to the highest quartile. Lower costs were found in records that indicated hospital location in the Midwest (27% lower, 95% CI [0.61-0.87], P<0.001), Northeast (34% lower, 95% CI [0.55-0.80], P<0.001) and South (39% lower, 95% CI [0.53-0.71], P<0.001) compared to the West.As demand for GAS increases with varying utilization and costs based on patient and hospital characteristics, there will likely be a need for more qualified surgeons, increased insurance coverage, and policies to ensure equitable access to GAS.
View details for DOI 10.1097/SLA.0000000000006296
View details for PubMedID 38618736
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EVALUATING THE REACH AND IMPLEMENTATION OF A BLADDER HEALTH EDUCATION PROGRAM USING AN IMPLEMENTATION SCIENCE FRAMEWORK
LIPPINCOTT WILLIAMS & WILKINS. 2023: E934
View details for Web of Science ID 000994549503087
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UTILIZATION OF GENDER-AFFIRMING SURGERY IN THE UNITED STATES FROM 2012-2019
WILEY. 2023: S177-S179
View details for Web of Science ID 001043021100178