Female urinary incontinence and treatment rates among a Medicare population
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Introduction and Hypothesis: The objective ofthis study was to determine the treatment rates of urinary incontinence (UI) in women 65 years old and older by education, poverty, and socioeconomic status (SES). Additionally, it was investigated ifhaving a discussion with a health care provider about UI had any effect on treatment rates. Methods: The publicly available 2007-2009 Medicare Health Outcome Survey data was examined in regards to four items that query about UI. All women 65 years old and older who provided data on UI and level of education were included in the analysis. United States Census Bureau data were used to establish poverty and SES variables. Results: In total, 87,805 women met inclusion criteria and 43.2% reported experiencing some UI in the past 6-months with only 28.6% receiving any treatment for UI. Women with a college education who self-reported either a "small" or "big" UI problem were more likely to receive treatment for their UI (OR = 0.84 (95% CI 0.79, 0.89)) and (OR= 0.77 (95% CI 0.69, 0.86). Women with a college education and any magnitude ofUI were also more likely to discuss their UI problem with a health care provider (OR = 0.93 (95% CI 0.88, 0.97)) and (OR= 0.80 (95% CI 0.72, 0.89)). For women with a small UI problem, a discussion with a provider was most impactful in regards to treatment for women without a college education. For women with a big UI problem, a discussion was most beneficial to treatment for women with a college education. Conclusion: UI is a prevalent condition among women 65 years old and older. Women without a college education are disadvantaged in regards to receiving any treatment for UI. Treatment rates may be improved among less educated women if providers initiate discussions regarding UI during the clinical encounter.
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