Increasing costs of urinary incontinence among female Medicare beneficiaries.
OBJECTIVE
We measured the financial burden of urinary incontinence in the United States from 1992 to 1998 among women 65 years old or older.


METHODS
We analyzed Medicare claims for 1992, 1995 and 1998 and estimated spending on the treatment of urinary incontinence. Total costs were stratified by type of service (inpatient, outpatient and emergency department).


RESULTS
Costs of urinary incontinence among older women nearly doubled between 1992 and 1998 in nominal dollars, from $128 million to $234 million, primarily due to increases in physician office visits and ambulatory surgery. The cost of inpatient services increased only slightly during the period. The increase in total spending was due almost exclusively to the increase in the number of women treated for incontinence. After adjusting for inflation, per capita treatment costs decreased about 15% during the study.


CONCLUSIONS
This shift from inpatient to outpatient care likely reflects the general shift of surgical procedures to the outpatient setting, as well as the advent of new minimally invasive incontinence procedures. In addition, increased awareness of incontinence and the marketing of new drugs for its treatment, specifically anticholinergic medication for overactive bladder symptoms, may have increased the number of office visits. While claims based Medicare expenditures are substantial, they do not include the costs of pads or medications and, therefore, underestimate the true financial burden of incontinence on the aging community.
Anger
Jennifer T
JT
Departments of Urology and Health Services, University of California-Los Angeles, David Geffen School of Medicine and School of Public Health, Los Angeles, CA 90095, USA. janger@mednet.ucla.edu
Saigal
Christopher S
CS
Madison
Rodger
R
Joyce
Geoffrey
G
Litwin
Mark S
MS
D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D006278:Medicare; D009819:Office Visits / Q000191:economics; D010044:Outpatient Clinics, Hospital / Q000191:economics; D014481:United States; D014549:Urinary Incontinence / Q000191:economics* / Q000628:therapy