title: Trends in inpatient female urinary incontinence surgery and costs in Taiwan, 1997-2011.
abstract: OBJECTIVE
  To explore the factors influencing the trends in incidence and cost for female inpatient urinary incontinence (UI) surgery from 1997 to 2011.
  
  
  METHODS
  A dataset of one million individuals was randomly drawn from the nationwide National Health Insurance claim database covering Taiwan's population from 1997 to 2011. The participants consisted of women aged ≥20 years who underwent UI surgery. We evaluated the trends of inpatient UI incidence, the medical cost of UI surgery, and the number of UI surgeries performed from 1997 to 2011.
  
  
  RESULTS
  A total of 1517 women underwent inpatient UI surgery from 1997 to 2011. Among these patients, the age-standardized incidence of UI surgery gradually trended upward from 1997 to 2010 but decreased in 2011. The trends were similar for medical costs, including annual inpatient cost, total medical service cost, and surgery fees. The annual inpatient cost had doubled in 2011 compared with that in 1997. However, physician visit fees, ward fees, and anesthesia fees started decreasing from 2005. The length of hospital stay and medication fees decreased during the 15-year study period. Surgeries by doctor specialty, hospital accreditation level, and patient age were stable for the study period.
  
  
  CONCLUSIONS
  The trends of age-standardized incidence of UI surgery, annual inpatient cost, total inpatient cost, and surgery fees increased significantly from 1997 to 2009, and abruptly decreased from 2010 to 2011. Long-term observation evaluating the impact of Diagnosis-Related Group payment system in Taiwan is warranted to verify in the future.
authors.affiliation: Graduate Institute of Business Administration, Fu-Jen Catholic University, Taipei, Taiwan; Fu-Jen Catholic University Hospital, Taiwan.
authors.forename: Keng-Ming
authors.initials: KM
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Fu-Jen Catholic University Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ching-Hung
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Department of Surgery, Division of Urology, Cardinal Tien Hospital, Taipei, Taiwan; Graduate Institute of Basic Medicine, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan. Electronic address: 053824@mail.fju.edu.tw.
authors.forename: Han-Sun
authors.initials: HS
authors.lastname: Chiang
authors.affiliation: Graduate Institute of Business Administration, Fu-Jen Catholic University, Taipei, Taiwan.
authors.forename: Tian-Shyug
authors.initials: TS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008875:Middle Aged; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014549:Urinary Incontinence / Q000191:economics* / Q000601:surgery*
keywords: cost; incidence; inpatient incontinence surgery; stress urinary incontinence; trend