The prevalence, burden, and treatment of urinary incontinence among women in a managed care plan.
OBJECTIVE
Urinary incontinence (UI) symptoms are common among women, yet only a small proportion of women with incontinence receive a diagnosis and treatment. We used survey and utilization data to determine the prevalence, burden, and treatment use for incontinence among women at Kaiser Permanente in Northern California.


METHODS
In 2002, we surveyed 6726 female health plan members about health issues, including incontinence. We assessed type and bothersomeness of incontinence symptoms in the previous 7 days. For survey respondents and a 10% sample of female plan members (n = 108,825), we assessed use from 1997 to 2003.


RESULTS
The survey response rate was 49.7% (3344 of 6726); 44% of respondents reported incontinence symptoms in the previous 7 days, with over half of these women reporting that these symptoms bothered them. Fifteen percent of women with incontinence symptoms had a diagnosis consistent with incontinence in the previous 5 years. One third of the women reporting current bothersome incontinence and 14 or more incontinence episodes in the last 7 days had a diagnosis consistent with incontinence in the previous 5 years. Among women who had received medical or surgical treatment for incontinence in the previous 5 years, approximately half currently report being bothered by their symptoms.


CONCLUSIONS
Prevalence of bothersome incontinence symptoms among females in a prepaid health plan is high. However, only a small proportion of these women received a diagnosis or treatment for incontinence symptoms in the last 5 years. Efforts to improve the detection and treatment of bothersome incontinence symptoms are needed.
Kinchen
Kraig S
KS
Outcomes Research, Eli Lilly and Company, Indianapolis, Indiana 46285, USA.
Lee
Janelle
J
Fireman
Bruce
B
Hunkeler
Enid
E
Nehemiah
Jerome L
JL
Curtice
Tammy G
TG
D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D019538:Health Care Surveys; D006279:Health Maintenance Organizations; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012648:Self Care; D012650:Self Disclosure; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration