Annual direct cost of urinary incontinence

OBJECTIVE: To estimate the annual direct cost of urinary incontinence in 19 95 US dollars. METHODS: Epidemiologically based models using diagnostic and treatment algo rithms from published clinical practice guidelines and current disease prev alence data were used to estimate direct costs of urinary incontinence. Pre valence and event probability estimates were obtained from literature sourc es, national data sets, small surveys, and expert opinion. Average national Medicare reimbursement was used to estimate costs, which were determined s eparately by gender, age group, and type of incontinence. Sensitivity analy ses were performed on all variables. RESULTS: The annual direct cost of urinary incontinence in the United State s (in 1995 dollars) was estimated as $16.3 billion, including $12.4 billion (76%) for women and $3.8 billion (24%) for men. Costs for community-dwelli ng women ($8.6 billion, 69% of costs for women) were greater than for insti tutionalized women ($3.8 billion, 31%). Costs for women over 65 years of ag e were more than twice the costs for those under 65 years ($7.6 and $3.6 bi llion, respectively). The largest cost category was routine care (70% of co sts for women), followed by nursing home admissions (14%), treatment (9%), complications (6%), and diagnosis and evaluations (1%). Costs were most sen sitive to changes in incontinence prevalence, routine care costs, and insti tutionalization rates and costs. CONCLUSION: Urinary incontinence is a very costly condition, with annual ex penditures similar to other chronic diseases in women. (C) 2001 by the Amer ican College of Obstetricians and Gynecologists.