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

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 o...

Full description

Saved in:
Bibliographic Details
Published in:Neurourology and urodynamics 2022-04, Vol.41 (4), p.918-925
Main Authors: McKinney, Jessica L., Datar, Manasi, Pan, Li‐Chen, Goss, Thomas, Keyser, Laura E., Pulliam, Samantha J.
Format: Article
Language:English
Subjects:
Clinical
Diagnosis
Female
health economics
healthcare resource utilization
Humans
Insurance Claim Review
Male
Patients
Physical therapy
Physical Therapy Modalities
Pregnancy
rehabilitation
Retrospective Studies
Statistical analysis
Urinary incontinence
Urinary Incontinence, Stress - therapy
Urinary Incontinence, Urge
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0733-2467
1520-6777
1520-6777
DOI:10.1002/nau.24913