Trends in Urodynamic Procedures, Surgical Procedures, and Overall Health Resource Utilization in the Adult Taiwanese Population with Urinary Incontinence: A Secondary Data Analysis

Lan Fang Hsu, Ling Yin Chang, Yuan Mei Liao, Shauh Der Yeh, Pei Shan Tsai

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The prevalence and incidence of the main risk factors for urinary incontinence (UI) have both increased over time. In addition, official statistics indicate that Taiwan is on course to evolve from an aging society into an aged society within the next decade. However, most of the studies in the literature that address the natural history of UI target Western and other non-Asian populations. Taiwan lacks knowledge of the natural history of UI. The aims of this research were to study the trends in the use of urodynamic and surgical procedures for various subtypes of UI and to investigate the relationship between UI and healthcare resource utilization. The data on 1 million, randomly selected people who were enrolled in the Taiwan National Health Insurance program between 2000 and 2008 were extracted from the Longitudinal Health Insurance Database. The population and all procedures were identified based on the International Classification of Disease, Ninth Revision, Clinical Modification codes. Annual incidence of UI was calculated on an annual basis, and trend analysis was performed using logistic regression models. The association between UI and healthcare utilization was examined using generalized linear models in a gamma distribution with a log link function. Overall, the trend in the annual incidence for all types of UI increased significantly (p < .01). Significantly increasing trends in the use of urodynamic procedures over time were observed for mixed and other types of UI (p < .01). In addition, a significantly increasing trend was observed in the annual rates of surgical procedures that were received by patients with urge or stress UI (p < .05). Patients with UI showed significantly higher healthcare resource utilization, including number of ambulatory visits, number of hospitalizations, average ambulatory care expenditures, and average days of hospitalization, than those without UI. However, limited information is available on the conservative treatment of UI in the database. UI symptoms may lead to increased healthcare resource utilization in patients with UI.

Original languageEnglish
Pages (from-to)438-445
Number of pages8
JournalJournal of Nursing Research
Volume26
Issue number6
DOIs
Publication statusPublished - Dec 1 2018

Fingerprint

Health Resources
Urodynamics
Urinary Incontinence
Population
Taiwan
Delivery of Health Care
National Health Programs
Incidence
Hospitalization
Logistic Models
Databases
Urge Urinary Incontinence
Stress Urinary Incontinence
International Classification of Diseases
Health Insurance
Ambulatory Care
Health Expenditures
Linear Models

Keywords

  • healthcare utilization
  • National Health Insurance Research Database
  • surgical procedures
  • urinary incontinence
  • urodynamic procedures

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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title = "Trends in Urodynamic Procedures, Surgical Procedures, and Overall Health Resource Utilization in the Adult Taiwanese Population with Urinary Incontinence: A Secondary Data Analysis",
abstract = "The prevalence and incidence of the main risk factors for urinary incontinence (UI) have both increased over time. In addition, official statistics indicate that Taiwan is on course to evolve from an aging society into an aged society within the next decade. However, most of the studies in the literature that address the natural history of UI target Western and other non-Asian populations. Taiwan lacks knowledge of the natural history of UI. The aims of this research were to study the trends in the use of urodynamic and surgical procedures for various subtypes of UI and to investigate the relationship between UI and healthcare resource utilization. The data on 1 million, randomly selected people who were enrolled in the Taiwan National Health Insurance program between 2000 and 2008 were extracted from the Longitudinal Health Insurance Database. The population and all procedures were identified based on the International Classification of Disease, Ninth Revision, Clinical Modification codes. Annual incidence of UI was calculated on an annual basis, and trend analysis was performed using logistic regression models. The association between UI and healthcare utilization was examined using generalized linear models in a gamma distribution with a log link function. Overall, the trend in the annual incidence for all types of UI increased significantly (p < .01). Significantly increasing trends in the use of urodynamic procedures over time were observed for mixed and other types of UI (p < .01). In addition, a significantly increasing trend was observed in the annual rates of surgical procedures that were received by patients with urge or stress UI (p < .05). Patients with UI showed significantly higher healthcare resource utilization, including number of ambulatory visits, number of hospitalizations, average ambulatory care expenditures, and average days of hospitalization, than those without UI. However, limited information is available on the conservative treatment of UI in the database. UI symptoms may lead to increased healthcare resource utilization in patients with UI.",
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