Urology · 2025
Economic Burden of Urinary Incontinence in Men With Prostate Cancer: Results From the Medical Expenditure Panel Survey (2016-2021).
СтатьяНазвание и аннотация: Перевод в очереди
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Slota Jennifer, Naser-Tavakolian Aurash, Ji Emily, Driscoll Conor, Arteaga Rebecca, Boehm Devin, Rosenfeld Jonathan, Raikar Aidan, Kim Jaewoo, Amarasekera Channa, Lee Ziho
Аннотация
OBJECTIVE: To evaluate the economic burden of urinary incontinence among prostate cancer survivors using nationally representative data, focusing on differences in healthcare expenditures and utilization between survivors with and without incontinence.
METHODS: We conducted a cross-sectional analysis using 2016-2021 data from the Medicare Expenditure Panel Survey. Men with self-reported prostate cancer were categorized by incontinence status. The primary outcome was the likelihood of incurring above-average total healthcare expenditures. Secondary outcomes included expenditures by care setting and frequency of outpatient visits. Survey-weighted multivariable logistic regression models were utilized to analyze expenditures, adjusting for age, race, insurance status, and education level.
RESULTS: The final weighted study population represented 3,060,848 prostate cancer survivors (76,759 with incontinence and 2,984,089 without). Survivors with incontinence were more often uninsured (8.9% vs 1.1%; P=.004) and less likely to have private insurance (2.5% vs 14.7%; P=.004). After adjustment, incontinence was associated with higher odds of above-average total expenditures (adjusted odds ratio [aOR] 2.33; 95% confidence interval [CI] 1.18-4.60; P=.015), largely driven by outpatient visits (aOR 3.81; 1.76-2.76; P=.001), outpatient expenditures (aOR 2.46; 95% CI 1.10-5.50; P=.029) and other non-facility-related expenditures (aOR 2.43; 95% CI 1.17-5.08; P=.018). Survivors with incontinence averaged 9 outpatient visits annually versus 6 among those without incontinence (P=.015).
CONCLUSION: Urinary incontinence significantly increases healthcare utilization and expenditures among prostate cancer survivors, particularly through outpatient care and incontinence-related medical supplies. Targeted strategies to prevent and manage incontinence may reduce long-term economic burden and improve survivorship care.
METHODS: We conducted a cross-sectional analysis using 2016-2021 data from the Medicare Expenditure Panel Survey. Men with self-reported prostate cancer were categorized by incontinence status. The primary outcome was the likelihood of incurring above-average total healthcare expenditures. Secondary outcomes included expenditures by care setting and frequency of outpatient visits. Survey-weighted multivariable logistic regression models were utilized to analyze expenditures, adjusting for age, race, insurance status, and education level.
RESULTS: The final weighted study population represented 3,060,848 prostate cancer survivors (76,759 with incontinence and 2,984,089 without). Survivors with incontinence were more often uninsured (8.9% vs 1.1%; P=.004) and less likely to have private insurance (2.5% vs 14.7%; P=.004). After adjustment, incontinence was associated with higher odds of above-average total expenditures (adjusted odds ratio [aOR] 2.33; 95% confidence interval [CI] 1.18-4.60; P=.015), largely driven by outpatient visits (aOR 3.81; 1.76-2.76; P=.001), outpatient expenditures (aOR 2.46; 95% CI 1.10-5.50; P=.029) and other non-facility-related expenditures (aOR 2.43; 95% CI 1.17-5.08; P=.018). Survivors with incontinence averaged 9 outpatient visits annually versus 6 among those without incontinence (P=.015).
CONCLUSION: Urinary incontinence significantly increases healthcare utilization and expenditures among prostate cancer survivors, particularly through outpatient care and incontinence-related medical supplies. Targeted strategies to prevent and manage incontinence may reduce long-term economic burden and improve survivorship care.