title: Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization.
abstract: OBJECTIVE
  We sought to estimate the frequency of self-reported fecal incontinence (FI), identify what proportion of these patients have a diagnosis of FI in their medical record, and compare health care costs and utilization in patients with different severities of FI to those without FI.
  
  
  METHODS
  Patients in a health maintenance organization were eligible and 1707 completed a survey. Patients with self-reported FI were assessed for a diagnosis of FI in their medical record for the last 5 years. Health care costs and utilization were obtained from claims data.
  
  
  RESULTS
  FI was reported by 36.2% of primary care patients, but only 2.7% of patients with FI had a medical diagnosis. FI adversely affected quality of life and severe FI was associated with 55% higher health care costs (including 77% higher gastrointestinal-related health care costs) compared to continent patients.
  
  
  CONCLUSIONS
  Increased screening of FI is needed.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC 27599-7080, USA.
authors.forename: Gena C
authors.initials: GC
authors.lastname: Dunivan
authors.forename: Steve
authors.initials: S
authors.lastname: Heymen
authors.forename: Olafur S
authors.initials: OS
authors.lastname: Palsson
authors.forename: Michael
authors.initials: M
authors.lastname: von Korff
authors.forename: Marsha J
authors.initials: MJ
authors.lastname: Turner
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Melville
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
mesh_terms: D000368:Aged; D005242:Fecal Incontinence / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D005260:Female; D017048:Health Care Costs; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D011788:Quality of Life; D014861:Washington / Q000453:epidemiology