Urologic diseases in America project: urinary incontinence in women-national trends in hospitalizations, office visits, treatment and economic impact.
OBJECTIVE
We describe temporal trends in hospitalizations, outpatient visits and the treatment of female urinary incontinence (UI), and estimated the costs of incontinence using national databases.


METHODS
The analytic methods used to generate these results have been described previously.


RESULTS
The rate of hospitalization with a primary diagnosis of UI decreased from 51/100,000 women in 1994 to 44/100,000 in 2000 and mean length of stay decreased from 3.1 days to 2.1. In contrast, outpatient visits for UI more than doubled during the same period from 845/100,000 women to 1,845/100,000. Rates of inpatient surgical treatment for UI decreased slightly from 1994 to 2000, while ambulatory surgical center visit rates for Medicare beneficiaries 65 years or older more than doubled from 60/100,000 in 1992 to 142/100,000 in 1998. Medical expenditures for UI increased substantially during the 1990s, almost doubling from 128.1 million dollars in 1992 to 234.4 million dollars in 1998 for Medicare beneficiaries 65 years or older. This increase was due almost entirely to increased outpatient costs, which increased from 25.4 million dollars or 9.1% of total costs in 1992 to 329 million dollars or 27.3% of total costs in 2000 in this group.


CONCLUSIONS
While existing national databases generally capture only the minority of incontinent women with UI who seek and receive care for UI, they are useful for documenting treads in service use and surgical treatments, and estimating economic impact. This data can be helpful when formulating public policy and designing observational and clinical studies.
Thom
David H
DH
Department of Family and Community Medicine, University of California-San Francisco, USA. dthom@itsa.ucsf.edu
Nygaard
Ingrid E
IE
Calhoun
Elizabeth A
EA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000191:economics / Q000453:epidemiology*