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

Autor: McKinney JL; Physical Therapy, School of Rehabilitation Sciences, Andrews University, Berrien Springs, Michigan, USA.; Renovia Inc., Boston, Massachusetts, USA., Datar M; Boston Healthcare Associates, Boston, Massachusetts, USA., Pan LC; Boston Healthcare Associates, Boston, Massachusetts, USA., Goss T; Boston Healthcare Associates, Boston, Massachusetts, USA., Keyser LE; Physical Therapy, School of Rehabilitation Sciences, Andrews University, Berrien Springs, Michigan, USA.; Renovia Inc., Boston, Massachusetts, USA., Pulliam SJ; Renovia Inc., Boston, Massachusetts, USA.; Obstetrics and Gynecology, Tufts University, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Neurourology and urodynamics [Neurourol Urodyn] 2022 Apr; Vol. 41 (4), pp. 918-925. Date of Electronic Publication: 2022 Mar 30.
DOI: 10.1002/nau.24913
Abstrakt: 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.
(© 2022 Renovia Inc. Neurourology and Urodynamics published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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