Evaluation of Financial Toxicity in Women Seeking Care for Urinary Incontinence.

Abstract

Importance: Only 25% of women seek treatment for urinary incontinence. Cost may be a potential barrier. Financial toxicity is the financial stress (ie, direct and indirect costs) associated with treatment of a condition. The subjective financial impact of urinary incontinence has not been previously measured in women.

Objective: This pilot study aimed to characterize the financial toxicity of urinary incontinence in women.

Study design: We performed a cross-sectional study of a convenience sample of women with urinary incontinence presenting to our urban, academic medical center. Surveys capturing degree of financial toxicity and urinary incontinence severity were administered. Descriptive data were analyzed using Student t tests and χ 2 tests for continuous and categorical variables respectively, with a significance threshold of P < 0.05.

Results: A total of 127/132 participants completed the survey. The majority identified as Latin-x (49.6%). Patients with moderate-to-severe financial toxicity due to urinary incontinence also had worse urinary incontinence symptom severity ( P < 0.019), lower levels of education ( P < 0.008), greater reliance on public services including insurance ( P < 0.008), lower household income ( P < 0.046), and a higher number of unmet social needs ( P < 0.001).

Conclusions: Women with moderate-to-severe financial toxicity related to urinary incontinence had worse urinary incontinence symptom severity and more unmet social needs. The COST-FACIT survey administered in women with urinary incontinence for the first time serves to characterize the subjective financial impact. Efforts to increase awareness of the cost burden of urinary incontinence may reveal cost-related barriers to care contributing to health care disparities among women with urinary incontinence.