title: Medical resource utilisation and cost of care for women seeking treatment for urinary incontinence in an outpatient setting. Examples from three countries participating in the PURE study.
abstract: OBJECTIVE
  To describe the medical resource use and direct costs of treatment for women with urinary incontinence (UI) in European countries.
  
  
  METHODS
  PURE is a non-interventional, observational study of patients seeking treatment for UI in an outpatient setting.
  
  
  METHODS
  Investigators being either general practitioners (GPs) and/or specialists, i.e. urologists and gynaecologists, in 14 European countries participated in PURE. The results for medical resource use and cost of treatment in Germany, Spain and the UK/Ireland recorded retrospectively at the enrolment visit for the preceding 12 months are presented here.
  
  
  METHODS
  Treatment-seeking women aged over 18 years who were under treatment or seeking treatment for UI, and who presented within the normal course of care for UI were enrolled in the 6 months study.
  
  
  METHODS
  Information on the incontinence resource use was gathered on standard data collection forms. The direct medical costs were calculated by attaching the unit costs from the perspective of the relevant health insurance in each country to the country-specific resource use. Furthermore, the contribution of patients to the costs of pads, or any treatment for UI was assessed.
  
  
  RESULTS
  Variation in medical resource use and cost of treatment between the three countries was observed, reflective of the differences in the healthcare systems and whether specialists and/or GPs provided the care. We found that women in Spain and Germany are more likely to have consulted a specialist for their UI symptoms, which had implications for utilisation of diagnostic procedures. Conservative treatment, particularly pelvis floor muscle exercises, was more common in patients in the UK/Ireland treated in primary care by GPs. In all three countries most of the women had used protective pads, which more than half the patients paying for them out-of-pocket, despite potential healthcare reimbursement schemes. Mean total UI-related costs per year ranged from 359 in the UK/Ireland for patients predominantly treated in the GP setting to 515 in Germany and 655 in Spain for patients treated by specialists and GPs.
  
  
  CONCLUSIONS
  Our study provides an estimation of resource use and costs associated with UI in treatment-seeking European women, exemplified here in three countries.
authors.affiliation: Eli Lilly and Company Limited, European Health Outcomes Research, Erl Wood Manor, Windlesham, Surrey, UK.
authors.forename: Sotiria
authors.initials: S
authors.lastname: Papanicolaou
authors.forename: Montserrat Espuna
authors.initials: ME
authors.lastname: Pons
authors.forename: Christian
authors.initials: C
authors.lastname: Hampel
authors.forename: Brigitta
authors.initials: B
authors.lastname: Monz
authors.forename: Deborah
authors.initials: D
authors.lastname: Quail
authors.forename: Matthias Graf von der
authors.initials: MG
authors.lastname: Schulenburg
authors.forename: Adrian
authors.initials: A
authors.lastname: Wagg
authors.forename: David
authors.initials: D
authors.lastname: Sykes
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D005194:Family Practice; D005260:Female; D005858:Germany / Q000453:epidemiology; D006176:Gynecology; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013030:Spain / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014549:Urinary Incontinence / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000523:psychology; D014572:Urology