Trends in Urodynamic Procedures, Surgical Procedures, and Overall Health Resource Utilization in the Adult Taiwanese Population With Urinary Incontinence: A Secondary Data Analysis

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Abstract

Background:

The prevalence and incidence of the main risk factors for urinary incontinence (UI) have both increased over time. In addition, official statistics indicate that Taiwan is on course to evolve from an aging society into an aged society within the next decade. However, most of the studies in the literature that address the natural history of UI target Western and other non-Asian populations. Taiwan lacks knowledge of the natural history of UI.

Purpose:

The aims of this research were to study the trends in the use of urodynamic and surgical procedures for various subtypes of UI and to investigate the relationship between UI and healthcare resource utilization.

Methods:

The data on 1 million, randomly selected people who were enrolled in the Taiwan National Health Insurance program between 2000 and 2008 were extracted from the Longitudinal Health Insurance Database. The population and all procedures were identified based on the International Classification of Disease, Ninth Revision, Clinical Modification codes. Annual incidence of UI was calculated on an annual basis, and trend analysis was performed using logistic regression models. The association between UI and healthcare utilization was examined using generalized linear models in a gamma distribution with a log link function.

Results:

Overall, the trend in the annual incidence for all types of UI increased significantly (p < .01). Significantly increasing trends in the use of urodynamic procedures over time were observed for mixed and other types of UI (p < .01). In addition, a significantly increasing trend was observed in the annual rates of surgical procedures that were received by patients with urge or stress UI (p < .05). Patients with UI showed significantly higher healthcare resource utilization, including number of ambulatory visits, number of hospitalizations, average ambulatory care expenditures, and average days of hospitalization, than those without UI. However, limited information is available on the conservative treatment of UI in the database.

Conclusions:

UI symptoms may lead to increased healthcare resource utilization in patients with UI.

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