Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;41(4):918-925.
doi: 10.1002/nau.24913. Epub 2022 Mar 30.

Retrospective claims analysis of physical therapy utilization among women with stress or mixed urinary incontinence

Jessica L McKinney  1   2 , Manasi Datar  3 , Li-Chen Pan  3 , Thomas Goss  3 , Laura E Keyser  1   2 , Samantha J Pulliam  2   4
Affiliations

Retrospective claims analysis of physical therapy utilization among women with stress or mixed urinary incontinence

Jessica L McKinney et al. Neurourol Urodyn. 2022 Apr.

Abstract

Objective: To describe the characteristics of women with stress or mixed urinary incontinence (SUI/MUI) receiving physical therapy (PT) services, including referral patterns and PT utilization.

Methods: Female patients with claims associated with an SUI or MUI diagnosis (International Classification of Disease-Clinical Modification [ICD-9-CM]: 625.6, 788.33, or ICD-10-CM: N39.3, N39.46) between July 01, 2014 and June 30, 2016 were identified in International business machines (IBM)'s MarketScan Research Database. Inclusion criteria included the absence of pregnancy claims and ≥80% medical and pharmacy enrollment pre- and postindex. First SUI/MUI diagnosis claim determined index. Patients were followed for 2 years, and associated UI-associated PT encounters were identified. Descriptive statistics were calculated for patients with at least one PT visit during the postindex period.

Results: In a cohort of 103,813 women with incident SUI or MUI diagnosis, 2.6% (2792/103,813) had at least one PT visit in the 2 years following their diagnosis. Mean age at index PT encounter was 50.55 years. A total of 52.36% (1462/2792) women had one to four PT visits; 21.2% (592/2792) had >8 PT visits. In subanalysis of the PT cohort (1345/2792), women who received PT only had the lowest average 2-year postindex total medical cost (mean: $12,671; SD: $16,346), compared with PT plus medications (mean: $27,394; SD: $64,481), and PT plus surgery (mean: $33,656; SD: $26,245), respectively. Over 40% had their first PT visit ≥3 months after their index date.

Conclusions: The percentage of women with a PT visit associated with an incident SUI or MUI diagnosis was low (2.6%), and 30% of this group completed three or more PT visits. This suggests poor adherence to clinical guidelines regarding supervised treatment of UI in women.

Impact statement: Our study suggests underutilization of PT among insured women with SUI and MUI in the 2 years following diagnosis. Interventions to improve this gap in first-line care may represent an opportunity for an increased role for PTs in the care of women with UI.

Keywords: health economics; healthcare resource utilization; physical therapy; rehabilitation; urinary incontinence.

PubMed Disclaimer

Conflict of interest statement

Manasi Datar, Li‐Chen Pan, and Thomas Goss are employees of Boston Healthcare Associates, a Veranex company, which received consulting fees from Renovia Inc. Jessica McKinney, Laura Keyser and Samantha Pulliam are employees of Renovia Inc.

Similar articles

See all similar articles

Cited by

References

    1. Dieter AA, Wilkins MF, Wu JM. Epidemiological trends and future care needs for pelvic floor disorders. Curr Opin Obs Gynecol. 2015;27(5):380‐384. 10.1097/GCO.0000000000000200 - DOI - PMC - PubMed
    1. Markland AD, Richter HE, Fwu C‐W, Eggers P, Kusek JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol. 2011;186(2):589‐593. 10.1016/j.juro.2011.03.114 - DOI - PMC - PubMed
    1. Haylen BT, De Ridder D, Freeman RM, et al. An International Urogynecological Association/International Continence Society Joint Report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4‐20. 10.1007/s00192-009-0976-9 - DOI - PubMed
    1. Odlum M, Davis N, Owens O, Preston M, Brewer R, Black D. Correlates and aetiological factors associated with hedonic well‐being among an ageing population of US men and women: secondary data analysis of a national survey. BMJ Open. 2018;8(11):e020962. 10.1136/bmjopen-2017-020962 - DOI - PMC - PubMed
    1. Chong EC, Khan AA, Anger JT. The financial burden of stress urinary incontinence among women in the United States. Curr Urol Rep. 2011;12(5):358‐362. 10.1007/s11934-011-0209-x - DOI - PubMed

Publication types