title: Barriers to pelvic floor physical therapy utilization for treatment of female urinary incontinence.
abstract: OBJECTIVE
  The purpose of this study was to estimate the effect of insurance status on pelvic floor physical therapy (PFPT) nonparticipation for the treatment of urinary incontinence.
  
  
  METHODS
  A cross-sectional study of women referred to PFPT for urinary incontinence between January 2009 and June 2010 was conducted. A telephone questionnaire was administered. Multiple logistic regression was used to identify risk factors for nonparticipation.
  
  
  RESULTS
  Thirty-three percent of women with private insurance and 17% with other insurance were PFPT nonparticipants. On multiple logistic regression, women with Medicare were more likely to participate in PFPT (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.01-0.72). Risk factors for nonparticipation included insurance noncoverage (OR, 103.85; 95% CI, 6.21-infinity) and a negative perception regarding the benefit of PFPT (OR, 5.07; 95% CI, 2.16-12.49).
  
  
  CONCLUSIONS
  Among women who were referred to PFPT for urinary incontinence, insurance noncoverage and negative patient perception of efficacy were risk factors for nonparticipation, although having Medicare was protective. Improving patient education and insurance coverage for PFPT may increase usage.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Blair B
authors.initials: BB
authors.lastname: Washington
authors.forename: Christina A
authors.initials: CA
authors.lastname: Raker
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005081:Exercise Therapy / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D007348:Insurance, Health; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010358:Patient Participation / Q000706:statistics & numerical data; D017773:Pelvic Floor; D026741:Physical Therapy Modalities / Q000191:economics / Q000706:statistics & numerical data*; D017149:Private Sector / Q000191:economics / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D014549:Urinary Incontinence / Q000175:diagnosis / Q000191:economics / Q000534:rehabilitation*