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High Costs of Urinary Incontinence Among Women Electing Surgery to Treat Stress Incontinence

2008; Lippincott Williams & Wilkins; Volume: 111; Issue: 4 Linguagem: Inglês

10.1097/aog.0b013e31816a1e12

1873-233X

Leslee L. Subak, Linda Brubaker, Toby C. Chai, Jennifer M. Creasman, Ananias C. Diokno, Patricia S. Goode, Stephen R. Kraus, John W. Kusek, Wendy W.J. de Leng, Emily S. Lukacz, Peggy Norton, Sharon L. Tennstedt,

Anorectal Disease Treatments and Outcomes

In Brief OBJECTIVE: To estimate costs for incontinence management, health-related quality of life, and willingness to pay for incontinence improvement in women electing surgery for stress urinary incontinence. METHODS: A total of 655 incontinent women enrolled in the Stress Incontinence Surgical Treatment Efficacy Trial, a randomized surgical trial. Baseline out-of-pocket costs for incontinence management were calculated by multiplying self-report of resources used (supplies, laundry, dry cleaning) by national resource costs ($2006). Health-related quality of life was estimated with the Health Utilities Index Mark 3. Participants estimated willingness to pay for 100% improvement in incontinence. Potential predictors of these outcomes were examined by using multivariable linear regression. RESULTS: Mean age was 52±10 years, and mean number of weekly incontinence episodes was 22±21. Mean and median (25%, 75% interquartile range) estimated personal costs for incontinence management among all women were $14±$24 and $8 (interquartile range $3, $18) per week, and 617 (94%) women reported any cost. Costs increased significantly with incontinence frequency and mixed compared with stress incontinence. The mean and median Health Utilities Index Mark 3 scores were 0.73±0.25 and 0.84 (interquartile range 0.63, 0.92). Women were willing to pay a mean of $118±$132 per month for complete resolution of incontinence, and willingness to pay increased significantly with greater expected incontinence improvement, household income, and incontinent episode frequency. CONCLUSION: Urinary incontinence is associated with substantial costs. Women spent nearly $750 per year out of pocket for incontinence management, had a significant decrement in quality of life, and were willing to pay nearly $1,400 per year for cure. LEVEL OF EVIDENCE: III Stress urinary incontinence is associated with substantial economic costs for incontinence management, decrement in health-related quality of life, and high willingness to pay for incontinence cure.