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Erschienen in: PharmacoEconomics 2/2004

01.02.2004 | Original Research Article

Cost of Stress Urinary Incontinence

A Claims Data Analysis

verfasst von: Dr. Howard G. Birnbaum, Stephanie A. Leong, Emily F. Oster, Kraig Kinchen, Peter Sun

Erschienen in: PharmacoEconomics | Ausgabe 2/2004

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Abstract

Objectives: The primary objectives of this research were to: (i) identify and present methodologies for estimating three types of ‘cost-of-illness’ measures using healthcare and disability claims data — specifically ‘cost of treatment’, ‘incremental cost of patient’, and ‘incremental cost of illness’; and (ii) perform a case-study analysis of these cost measures for women treated for stress urinary incontinence (SUI).
Study Design and Methods: In this paper, we discuss aspects of cost-of-illness methodologies in the context of SUI. We first distinguish between ‘cost of treatment’ (i.e. the costs of treating a specific condition), ‘incremental cost of patient’ (i.e. the additional costs associated with patients with a particular condition, irrespective of any comorbid conditions they may also have), and ‘incremental cost of illness’ (i.e. the additional costs resulting from a particular illness, as distinct from the costs of other conditions that the patient might have, including conditions which might have caused the illness in question). The latter case is in many ways the most complex to model, requiring controls for related causal conditions. We then applied these three methodologies by analysing the costs associated with SUI. Using data from a large employer claims database (n >100 000), we estimated a series of regression models that reflected cost of treatment, incremental cost of patient, and incremental cost of illness for SUI.
Results: The three approaches yielded substantially different results. For many purposes the incremental cost-of-illness model provides the most appropriate results, as it controls for comorbid conditions, as well as patient demographics. On a per capita basis using the incremental cost-of-illness model, patients with SUI had direct costs that were 134% more than those for their controls and indirect costs that were 163% more than those for controls. Estimating costs for the average (i.e. mean) person results in dollar-termed estimates of the costs of SUI. In particular, we found that in 1998, the average direct medical cost of SUI was $US5642 and the indirect workplace cost of SUI was $US4208.
Conclusions: Since the various methods yield substantially different results, it is important that the end user of cost-of-illness analyses of claims data have a clear purpose in mind when reporting the cost of the condition of concern. The incremental cost-of-illness measure for claims data has substantial advantages in terms of enhancing our understanding of the specific cost impact of SUI.
Fußnoten
1
It is also possible to estimate the costs at the median of the sample. When we use the mean, the correct interpretation is that the direct medical cost of SUI is $US5642 for the mean individual. If we used the median, the interpretation would centre around the median individual and the cost estimate would be $US2805.
 
Literatur
1.
Zurück zum Zitat Centers for Medicaid & Medicare Services, Office of the Actuary: National Health Statistics Group; US Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census. National health expenditures aggregate and per capita amounts, percent distribution, and average annual percent growth, by source of funds: selected calendar years 1980–2000 [online]. Available from URL: http://cms.hhs.gov/statistics/nhe/historical/tI.asp [Accessed 2002 Sep 18] Centers for Medicaid & Medicare Services, Office of the Actuary: National Health Statistics Group; US Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census. National health expenditures aggregate and per capita amounts, percent distribution, and average annual percent growth, by source of funds: selected calendar years 1980–2000 [online]. Available from URL: http://​cms.​hhs.​gov/​statistics/​nhe/​historical/​tI.​asp [Accessed 2002 Sep 18]
2.
Zurück zum Zitat Rice DP. Estimating the cost of illness. Washington, DC: US Department of Health, Economics and Welfare, 1966 Rice DP. Estimating the cost of illness. Washington, DC: US Department of Health, Economics and Welfare, 1966
3.
Zurück zum Zitat Bloom BS, Bruno DJ, Maman DY, et al. Usefulness of US costof-illness studies in healthcare decision making. Pharmacoeconomics 2001; 19 (2): 207–13PubMed Bloom BS, Bruno DJ, Maman DY, et al. Usefulness of US costof-illness studies in healthcare decision making. Pharmacoeconomics 2001; 19 (2): 207–13PubMed
4.
Zurück zum Zitat Birnbaum H, Morley M, Greenberg P, et al. Economic burden of pneumonia in an employed population. Arch Intern Med 2001; 161: 2725–31PubMed Birnbaum H, Morley M, Greenberg P, et al. Economic burden of pneumonia in an employed population. Arch Intern Med 2001; 161: 2725–31PubMed
5.
Zurück zum Zitat Brecht JG, Poldrugo F, Schadlich PK. Alcoholism: the cost of illness in the Federal Republic of Germany. Pharmacoeconomics 1996 Nov; 10 (5): 484–93PubMed Brecht JG, Poldrugo F, Schadlich PK. Alcoholism: the cost of illness in the Federal Republic of Germany. Pharmacoeconomics 1996 Nov; 10 (5): 484–93PubMed
6.
Zurück zum Zitat Greenberg P, Stiglin L, Finkelstein S, et al. The economic burden of depression in 1990. J Clin Psychiatry 1993; 54 (11): 405–18PubMed Greenberg P, Stiglin L, Finkelstein S, et al. The economic burden of depression in 1990. J Clin Psychiatry 1993; 54 (11): 405–18PubMed
7.
Zurück zum Zitat Henriksson F, Jonsson B. The economic cost of multiple sclerosis in Sweden in 1994. Pharmacoeconomics 1998; 13 (5): 597–606PubMed Henriksson F, Jonsson B. The economic cost of multiple sclerosis in Sweden in 1994. Pharmacoeconomics 1998; 13 (5): 597–606PubMed
8.
Zurück zum Zitat Hodgson T, Cohen AJ. Medical expenditures for major diseases, 1995. Health Care Financ Rev 1999; 21 (2): 119–64PubMedPubMedCentral Hodgson T, Cohen AJ. Medical expenditures for major diseases, 1995. Health Care Financ Rev 1999; 21 (2): 119–64PubMedPubMedCentral
9.
Zurück zum Zitat Hodgson T, Cohen AJ. Medical care expenditures for selected circulatory diseases. Med Care 1999; 37 (10): 994–1012PubMed Hodgson T, Cohen AJ. Medical care expenditures for selected circulatory diseases. Med Care 1999; 37 (10): 994–1012PubMed
10.
Zurück zum Zitat Hodgson T, Cai L. Medical care expenditures for hypertension, its complications and its comorbidities. Med Care 2001; 39 (6: 599–615PubMed Hodgson T, Cai L. Medical care expenditures for hypertension, its complications and its comorbidities. Med Care 2001; 39 (6: 599–615PubMed
11.
Zurück zum Zitat Niederman MS, McCombs JS, Unger AN, et al. The cost of treating community-acquired pneumonia. Clin Ther 1998 JulAug; 20 (4): 820–37 Niederman MS, McCombs JS, Unger AN, et al. The cost of treating community-acquired pneumonia. Clin Ther 1998 JulAug; 20 (4): 820–37
12.
Zurück zum Zitat Reginster JY, Gillet P, Ben Sedrine W, et al. Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 1999 May; 15 (5): 507–14PubMed Reginster JY, Gillet P, Ben Sedrine W, et al. Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 1999 May; 15 (5): 507–14PubMed
13.
Zurück zum Zitat Rouillon F, Toumi M, Dansette GY, et al. Some aspects of the cost of schizophrenia in France. Pharmacoeconomics 1997 Jun; 11 (6: 578–94PubMed Rouillon F, Toumi M, Dansette GY, et al. Some aspects of the cost of schizophrenia in France. Pharmacoeconomics 1997 Jun; 11 (6: 578–94PubMed
14.
Zurück zum Zitat Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 1998; 25: 723–46PubMed Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 1998; 25: 723–46PubMed
16.
Zurück zum Zitat Diokno AC, Burgio K, Fultz H, et al. Prevalence and outcomes of continence surgery in community dwelling women. J Urol 2003 Aug; 170 (2 Pt 1): 507–11PubMed Diokno AC, Burgio K, Fultz H, et al. Prevalence and outcomes of continence surgery in community dwelling women. J Urol 2003 Aug; 170 (2 Pt 1): 507–11PubMed
17.
Zurück zum Zitat Isselbacher KJ, Braunwald E, Wilson JD, et al., editors. Harrison’s principles of internal medicine. New York (NY): McGraw-Hill Inc, 1994 Isselbacher KJ, Braunwald E, Wilson JD, et al., editors. Harrison’s principles of internal medicine. New York (NY): McGraw-Hill Inc, 1994
18.
Zurück zum Zitat Ekelund P, Grimby A, Milsom I. Urinary incontinence: social and financial costs high [letter]. BMJ 1993; 306 (6888): 1344PubMedPubMedCentral Ekelund P, Grimby A, Milsom I. Urinary incontinence: social and financial costs high [letter]. BMJ 1993; 306 (6888): 1344PubMedPubMedCentral
19.
Zurück zum Zitat DuBeau CE. Urinary incontinence. Clin Geriatr 2001; 9 (6): 31–47 DuBeau CE. Urinary incontinence. Clin Geriatr 2001; 9 (6): 31–47
20.
Zurück zum Zitat Leach GE, Dmochowski RR, Appell RA, et al. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary inconti nence. The American Urological Association. J Uro11997 Sep; 158 (3 Pt 1): 875–80PubMed Leach GE, Dmochowski RR, Appell RA, et al. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary inconti nence. The American Urological Association. J Uro11997 Sep; 158 (3 Pt 1): 875–80PubMed
21.
Zurück zum Zitat Wagner TH, Hu TW. Economic costs of urinary incontinence in 1995. Urology 1998; 51: 355–61 Wagner TH, Hu TW. Economic costs of urinary incontinence in 1995. Urology 1998; 51: 355–61
22.
Zurück zum Zitat Wilson L, Brown IS, Shin GP, et al. Annual direct cost of urinary incontinence. Obstet Gynecol 2001; 98: 398–406PubMed Wilson L, Brown IS, Shin GP, et al. Annual direct cost of urinary incontinence. Obstet Gynecol 2001; 98: 398–406PubMed
23.
Zurück zum Zitat Hu TW. Impact of urinary incontinence on health-care costs. J Am Geriatr Soc 1990; 38: 292–5PubMed Hu TW. Impact of urinary incontinence on health-care costs. J Am Geriatr Soc 1990; 38: 292–5PubMed
24.
Zurück zum Zitat Ramsey SD, Wagner TH, Bavendam TG. Estimated costs of treating stress urinary incontinence in elderly women according to the AHCPR clinical practice guidelines. Am J Manag Care 1996; 2: 147–54 Ramsey SD, Wagner TH, Bavendam TG. Estimated costs of treating stress urinary incontinence in elderly women according to the AHCPR clinical practice guidelines. Am J Manag Care 1996; 2: 147–54
25.
Zurück zum Zitat Ouslander JG, Kane RL. The costs of urinary incontinence in nursing homes. Med Care 1984; 22: 69–79PubMed Ouslander JG, Kane RL. The costs of urinary incontinence in nursing homes. Med Care 1984; 22: 69–79PubMed
26.
Zurück zum Zitat Schnell J, Sowell V, Hu T, et al. Reduction of urinary incontinence in nursing homes: Does it reduce or increase costs? J Am Geriatr Soc 1988; 36: 34–9 Schnell J, Sowell V, Hu T, et al. Reduction of urinary incontinence in nursing homes: Does it reduce or increase costs? J Am Geriatr Soc 1988; 36: 34–9
27.
Zurück zum Zitat Cella M. The nursing costs of urinary incontinence in a nursing home population. Nurs Clin North Am 1988; 23: 159–68PubMed Cella M. The nursing costs of urinary incontinence in a nursing home population. Nurs Clin North Am 1988; 23: 159–68PubMed
28.
Zurück zum Zitat Hall JA, Nelson MA, Meyer JW, et al. Costs and resources associated with the treatment of overactive bladder using retrospective medical care claims data. Manag Care Interface 2001; 14: 69–75PubMed Hall JA, Nelson MA, Meyer JW, et al. Costs and resources associated with the treatment of overactive bladder using retrospective medical care claims data. Manag Care Interface 2001; 14: 69–75PubMed
29.
Zurück zum Zitat Day PL. Findings of a three-year retrospective study to investigate prevalence and incidence of urinary incontinence and overactive bladder in a typical managed care setting. Pharm Pract Manag Q 2000; 20: 1–11PubMed Day PL. Findings of a three-year retrospective study to investigate prevalence and incidence of urinary incontinence and overactive bladder in a typical managed care setting. Pharm Pract Manag Q 2000; 20: 1–11PubMed
30.
Zurück zum Zitat Barnett A, Birnbaum H, Cremieux PY, et al. The cost of cancer to a major employer in the United States: a case-control analysis. Am J Manag Care 2000; 6: 1243–51PubMed Barnett A, Birnbaum H, Cremieux PY, et al. The cost of cancer to a major employer in the United States: a case-control analysis. Am J Manag Care 2000; 6: 1243–51PubMed
31.
Zurück zum Zitat Birnbaum H, Claxton A, Leong S, et al. Economic outcomes of women with stress urinary incontinence: an employer perspective. Poster presented at The American College of Obstetricians and Gynecologists’ 50th annual clinical meeting; 2002 May 4–8; Los Angeles Birnbaum H, Claxton A, Leong S, et al. Economic outcomes of women with stress urinary incontinence: an employer perspective. Poster presented at The American College of Obstetricians and Gynecologists’ 50th annual clinical meeting; 2002 May 4–8; Los Angeles
32.
Zurück zum Zitat Brown IS, Grady D, Ouslander JG, et al. Prevalence of urinary incontinence and associated risk factors in postmenopausal women. Obstet Gynecol 1999; 94: 66–70PubMed Brown IS, Grady D, Ouslander JG, et al. Prevalence of urinary incontinence and associated risk factors in postmenopausal women. Obstet Gynecol 1999; 94: 66–70PubMed
33.
Zurück zum Zitat Buchsbaum G, Chin M, Glantz C, et al. Prevalence of urinary incontinence and associated risk factors in a cohort of nuns. Obstet Gynecol 2002; 100: 226–9PubMed Buchsbaum G, Chin M, Glantz C, et al. Prevalence of urinary incontinence and associated risk factors in a cohort of nuns. Obstet Gynecol 2002; 100: 226–9PubMed
34.
Zurück zum Zitat Burgio KL, Matthews KA, Engel BT. Prevalence, incidence, and correlates of urinary incontinence in healthy, middle-aged women. J Urol 1991; 146: 1255–9PubMed Burgio KL, Matthews KA, Engel BT. Prevalence, incidence, and correlates of urinary incontinence in healthy, middle-aged women. J Urol 1991; 146: 1255–9PubMed
35.
Zurück zum Zitat Diokno AC, Brock BM, Herzog AR. Medical correlates of urinary incontinence in the elderly. Urology 1990; 36: 129–38 36PubMed Diokno AC, Brock BM, Herzog AR. Medical correlates of urinary incontinence in the elderly. Urology 1990; 36: 129–38 36PubMed
36.
Zurück zum Zitat Hampel C, Wienhold D, Benken N. Definition of overactive bladder and epidemiology of urinary incontinence. Urology 1997; 50 Suppl. 6A: 4–14 Hampel C, Wienhold D, Benken N. Definition of overactive bladder and epidemiology of urinary incontinence. Urology 1997; 50 Suppl. 6A: 4–14
37.
Zurück zum Zitat Hunskaar S, Arnold EP, Burgio K, et al. Epidemiology and natural history of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2000; 11: 301–19PubMed Hunskaar S, Arnold EP, Burgio K, et al. Epidemiology and natural history of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2000; 11: 301–19PubMed
38.
Zurück zum Zitat Muscatello DJ, Rissel C, Szonyi G. Urinary symptoms and incontinence in an urban community: prevalence and associated factors in older men and women. Intern Med 12001; 31: 151–60 Muscatello DJ, Rissel C, Szonyi G. Urinary symptoms and incontinence in an urban community: prevalence and associated factors in older men and women. Intern Med 12001; 31: 151–60
39.
Zurück zum Zitat Nygaard IE, Lemke JH. Urinary incontinence in rural older women: prevalence, incidence, and remission. J Am Geriatr Soc 1996; 44: 1049–54PubMed Nygaard IE, Lemke JH. Urinary incontinence in rural older women: prevalence, incidence, and remission. J Am Geriatr Soc 1996; 44: 1049–54PubMed
40.
Zurück zum Zitat Sampsele CM, Harlow SD, Skurnick J, et al. Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women. Obstet Gynecol 2002; 100: 1230–8 Sampsele CM, Harlow SD, Skurnick J, et al. Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women. Obstet Gynecol 2002; 100: 1230–8
41.
Zurück zum Zitat Schmidbauer J, Temml C, Schatzl G, et al. Risk factors for urinary incontinence in both sexes. Fur Urol 2001; 39: 565–70 Schmidbauer J, Temml C, Schatzl G, et al. Risk factors for urinary incontinence in both sexes. Fur Urol 2001; 39: 565–70
42.
Zurück zum Zitat Vinker S, Kaplan B, Nakar S, et al. Urinary incontinence in women: prevalence, characteristics and effect on quality of life: a primary care clinic study. Isr Med Assoc J 2001; 3: 663–6PubMed Vinker S, Kaplan B, Nakar S, et al. Urinary incontinence in women: prevalence, characteristics and effect on quality of life: a primary care clinic study. Isr Med Assoc J 2001; 3: 663–6PubMed
43.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (5): 373–83PubMed Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (5): 373–83PubMed
44.
Zurück zum Zitat Duan N. Smearing estimate: a nonparametric retransformation method. J Am Stat Assoc 1983; 78: 605–10 Duan N. Smearing estimate: a nonparametric retransformation method. J Am Stat Assoc 1983; 78: 605–10
45.
Zurück zum Zitat Birnbaum H, Cremieux P, Greenberg P, et al. Using healthcare claims data for outcomes research and pharmacoeconomic analyses. Pharmacoeconomics 1999; 16 (1): 1–8PubMed Birnbaum H, Cremieux P, Greenberg P, et al. Using healthcare claims data for outcomes research and pharmacoeconomic analyses. Pharmacoeconomics 1999; 16 (1): 1–8PubMed
46.
Zurück zum Zitat Shaw C. A review of the psychosocial predictors of helpseeking behavior and impact on quality of life in people with urinary incontinence. J Clin Nurs 2001; 10: 15–24PubMed Shaw C. A review of the psychosocial predictors of helpseeking behavior and impact on quality of life in people with urinary incontinence. J Clin Nurs 2001; 10: 15–24PubMed
Metadaten
Titel
Cost of Stress Urinary Incontinence
A Claims Data Analysis
verfasst von
Dr. Howard G. Birnbaum
Stephanie A. Leong
Emily F. Oster
Kraig Kinchen
Peter Sun
Publikationsdatum
01.02.2004
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 2/2004
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200422020-00003

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