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Health status, comorbidities and cost-of-illness in females with stress urinary incontinence

I. Koenig1, C. Moetteli1, H. Luginbuehl1, L. Radlinger1, A. Kuhn1, J. Taeymans1 (1Bern)


Einleitung

The mean prevalence of stress urinary incontinence is 35%. Two thirds of women suffering from SUI reported a negative impact on quality of life. SUI implies a substantial economic burden on the health care and social services of many European countries. Direct medical and direct non-medical costs of SUI amounted over one billion Euro in Germany (2011) while another billion Euro was spent for SUI-related care in nursing homes. As the economic burden of SUI in Switzerland is, as yet, not well reported, the aim of this study was to estimate the health status and the health costs of women with SUI. 

Methodik
This cost-of-illness study (COI) was embedded in a Randomized Controlled Trial exploring the effect of two pelvic floor muscle (PFM) training protocols. This COI study took a societal perspective while a bottom-up approach was applied. Health status as well as cost data were collected using a self-reported diary during the 16-weeks of physiotherapy intervention period. Descriptive statistics were used to analyze the demographic and the cost data. A frequency analysis was conducted for the comorbidities, for the direct (medical and non-medical) and indirect costs.
Resultate

Thirty-seven participants volunteered in this COI study. Two participants had 10 comorbidities. The most commonly reported problem was back pain (48%), 51% of the participant consulted a medical doctor. The prevalence of drug consumption was 70%. Furthermore, 11% reported to be less efficient while working and 30% less physical active. SUI-related mental stress was mentioned by 59.5%. The average health costs (16-weeks) were CHF 2256.-, the average direct medical costs CHF 1641.-. 

Schlussfolgerungen
The prevalence of comorbidities was comparable to obese females. 33% of the volunteers reported SUI-related limitations of their physical activity. It is well documented that low physical activity is related to more comorbidity. This illustrates the important public health impact of SUI. The average health care cost was 30% higher as compared to general Swiss female population of similar age group.
Bedeutung

The high economic burden of SUI requires cost-effective clinical treatments. Physiotherapy is recommended by the International Consultation on Incontinence (ICI) as first-line therapy in the treatment of all forms of female urinary incontinence since its effectiveness could be shown. Consequently, physiotherapy could contribute to a reduction in the cost of health care.