title: Economic cost of fecal incontinence.
abstract: BACKGROUND
  Despite its prevalence and deleterious impact on patients and families, fecal incontinence remains an understudied condition. Few data are available on its economic burden in the United States.
  
  
  OBJECTIVE
  The aim of this study was to quantify per patient annual economic costs associated with fecal incontinence.
  
  
  METHODS
  A mail survey of patients with fecal incontinence was conducted in 2010 to collect information on their sociodemographic characteristics, fecal incontinence symptoms, and utilization of medical and nonmedical resources for fecal incontinence. The analysis was conducted from a societal perspective and included both direct and indirect (ie, productivity loss) costs. Unit costs were determined based on standard Medicare reimbursement rates, national average wholesale prices of medications, and estimates from other relevant sources. All cost estimates were reported in 2010 US dollars.
  
  
  METHODS
  This study was conducted at a single tertiary care institution.
  
  
  METHODS
  The analysis included 332 adult patients who had fecal incontinence for more than a year with at least monthly leakage of solid, liquid, or mucous stool.
  
  
  METHODS
  The primary outcome measured was the per patient annual economic costs associated with fecal incontinence.
  
  
  RESULTS
  The average annual total cost for fecal incontinence was $4110 per person (median = $1594; interquartile range, $517-$5164). Of these costs, direct medical and nonmedical costs averaged $2353 (median, $1176; interquartile range, $294-$2438) and $209 (median, $75; interquartile range, $17-$262), whereas the indirect cost associated with productivity loss averaged $1549 per patient annually (median, $0; interquartile range, $0-$813). Multivariate regression analyses suggested that greater fecal incontinence symptom severity was significantly associated with higher annual direct costs.
  
  
  CONCLUSIONS
  This study was based on patient self-reported data, and the sample was derived from a single institution.
  
  
  CONCLUSIONS
  Fecal incontinence is associated with substantial economic cost, calling for more attention to the prevention and effective management of this condition.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA. xiao.xu@yale.edu
authors.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.forename: Stacy B
authors.initials: SB
authors.lastname: Menees
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Zochowski
authors.forename: Dee E
authors.initials: DE
authors.lastname: Fenner
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005242:Fecal Incontinence / Q000191:economics* / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology