Jennifer Slota, Aurash Naser-Tavakolian, Emily Ji, Conor Driscoll, Rebecca Arteaga, Devin Boehm, Jonathan Rosenfeld, Aidan Raikar, Jaewoo Kim, Channa Amarasekera, Ziho Lee
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Survey-weighted multivariable logistic regression models were utilized to analyze expenditures, adjusting for age, race, insurance status, and education level.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Economic Burden of Urinary Incontinence in Men With Prostate Cancer: Results From the Medical Expenditure Panel Survey (2016-2021).\",\"authors\":\"Jennifer Slota, Aurash Naser-Tavakolian, Emily Ji, Conor Driscoll, Rebecca Arteaga, Devin Boehm, Jonathan Rosenfeld, Aidan Raikar, Jaewoo Kim, Channa Amarasekera, Ziho Lee\",\"doi\":\"10.1016/j.urology.2025.09.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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). 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引用次数: 0
摘要
目的:利用具有全国代表性的数据,评估前列腺癌幸存者尿失禁的经济负担,重点研究有尿失禁和无尿失禁幸存者在医疗支出和利用方面的差异。方法:我们使用2016-2021年医疗保险支出小组调查的数据进行了横断面分析。自我报告患有前列腺癌的男性根据尿失禁状况进行分类。主要结果是产生高于平均水平的总医疗支出的可能性。次要结果包括护理环境和门诊就诊频率的支出。使用调查加权多变量logistic回归模型分析支出,调整年龄、种族、保险状况和教育水平。结果:最终加权研究人群为3060848名前列腺癌幸存者(76759名失禁患者和2984089名无失禁患者)。尿失禁幸存者通常没有保险(8.9% vs 1.1%; p=0.004),很少有私人保险(2.5% vs 14.7%; p=0.004)。调整后,尿失禁与总支出高于平均水平的几率较高相关(调整比值比[aOR] 2.33; 95%可信区间[CI] 1.18-4.60; p=0.015),主要由门诊就诊(aOR 3.81; 1.76-2.76; p=0.001)、门诊支出(aOR 2.46; 95% CI 1.10-5.50; p=0.029)和其他与医院无关的支出(aOR 2.43; 95% CI 1.17-5.08; p=0.018)驱动。尿失禁幸存者平均每年9次门诊就诊,而无尿失禁者为6次门诊就诊(p=0.015)。结论:尿失禁显著增加前列腺癌幸存者的医疗保健利用和支出,特别是通过门诊护理和尿失禁相关的医疗用品。有针对性的策略预防和管理尿失禁可以减少长期的经济负担和改善生存护理。
Economic Burden of Urinary Incontinence in Men With Prostate Cancer: Results From the Medical Expenditure Panel Survey (2016-2021).
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.
期刊介绍:
Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology
The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.