Incontinence Research Today is a free monthly online journal that collates and summarizes the latest research about Incontinence, including details on urinary incontinence, bladder control, treatment, causes.

Increasing costs of urinary incontinence among female Medicare beneficiaries.

Anger JT, Saigal CS, Madison R, Joyce G, Litwin MS,

Departments of Urology and Health Services, University of California-Los Angeles, David Geffen School of Medicine and School of Public Health, Los Angeles, CA 90095, USA. janger@mednet.ucla.edu

PURPOSE: We measured the financial burden of urinary incontinence in the United States from 1992 to 1998 among women 65 years old or older. MATERIALS AND METHODS: We analyzed Medicare claims for 1992, 1995 and 1998 and estimated spending on the treatment of urinary incontinence. Total costs were stratified by type of service (inpatient, outpatient and emergency department). RESULTS: Costs of urinary incontinence among older women nearly doubled between 1992 and 1998 in nominal dollars, from $128 million to $234 million, primarily due to increases in physician office visits and ambulatory surgery. The cost of inpatient services increased only slightly during the period. The increase in total spending was due almost exclusively to the increase in the number of women treated for incontinence. After adjusting for inflation, per capita treatment costs decreased about 15% during the study. CONCLUSIONS: This shift from inpatient to outpatient care likely reflects the general shift of surgical procedures to the outpatient setting, as well as the advent of new minimally invasive incontinence procedures. In addition, increased awareness of incontinence and the marketing of new drugs for its treatment, specifically anticholinergic medication for overactive bladder symptoms, may have increased the number of office visits. While claims based Medicare expenditures are substantial, they do not include the costs of pads or medications and, therefore, underestimate the true financial burden of incontinence on the aging community.

Published 6 June 2006 in J Urol, 176(1): 247-51; discussion 251.
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