The prevalence of urinary incontinence and its burden on the quality of life among older adults with medicare supplement insurance
- 283 Downloads
Estimate the prevalence and burden of urinary incontinence (UI) on the quality of life (QOL) among adults (65 or older) with Medigap insurance.
Data were obtained from the health update survey (HUS), which contains questions on demographics, comorbid conditions, and the Veteran’s RAND 12-item health status survey. The mail survey was fielded on a random sample of 15,000 insureds from 10 states in 2008. Respondents were divided into those with UI and others, based on their response to a question about leaking urine during the last six months. Univariate and multivariate analyses were conducted to estimate the likelihood of UI and its impact on QOL while controlling for respondent demographics and comorbid conditions.
Of the 5,530 eligible respondents, 37.5% reported having UI. The strongest predictors of UI were female gender, advancing age, and obesity. All the QOL estimates were significantly lower for those with UI (P < 0.001). Further, UI had a stronger influence on QOL than did diabetes, cancer, and arthritis, particularly from a mental health standpoint.
Consistent with other Medicare populations (e.g. Medicare managed care), UI was common in Medigap insureds, strongly associated with lower QOL affecting mental, physical, and social well-being, and is often untreated.
KeywordsUrinary incontinence Outcomes assessment Medigap insurance Quality of life
Body mass index
Health outcomes survey
Health update survey
Mental component score
Ordinary least squares
Physical component score
Quality of life
Relative risk ratios
The authors thank Frank G. Bottone, Jr., PhD of Ingenix for his editorial assistance.
- 10.Board on Health Care Services. Retooling for an Aging America: Building the Health Care Workforce. (2008). Report. Institute of Medicine. http://www.iom.edu/Reports/2008/Retooling-for-an-Aging-America-Building-the-Health-Care-Workforce.aspx. Accessed 3 Dec 2010.
- 11.U.S. Department of Health and Human Services. Center for Disease Control and Prevention. National Center for Health Statistics. (2007). Health, United States, 2007. With Chartbook on Trends in the Health of Americans. Hyattsville, MD. http://www.cdc.gov/nchs/data/hus/hus07.pdf. Accessed 3 Dec 2010.
- 20.Kosinski, M. Bayliss, M., Bjorner, J. B., & Ware, J. E. (2000). Improving estimates of SF-36® health survey scores for respondents in missing data. Medical Outcomes Trust Monitor, Fall.Google Scholar
- 21.Ware, J. E., Kosinski, M., Turner-Bowker, D. M., & Gandek, B. (2002). SF-12v2™: How to score version 2 of the SF-12® health survey. Lincoln, RI: QualityMetric Incorporated.Google Scholar
- 28.Tennstedt, S. L., Link, C. L., Steers, W. D., & McKinlay, J. B. (2008). Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults: The Boston Area Community Health (BACH) Survey. American Journal of Epidemiology, 167(4), 390–399.PubMedCrossRefGoogle Scholar
- 30.National Committee for Quality Assurance HEDIS®. (2008). Volume 6: Specifications for the Medicare Health Outcomes Survey. Washington, DC: NCQA Publication. http://www.hosonline.org/surveys/hos/download/HOS_SampleBaseline_C11.pdf. Accessed 3 Dec 2010.