Primary and Specialty Outpatient Visits for Older Women With Urinary Incontinence: A Comparison of Nurses to the General Population.

We evaluated patterns of outpatient visits seen for urinary incontinence (UI) among women 65 years or older in the Nurses' Health Study and the general Medicare population. We were interested in understanding whether nurses, with high health literacy, may receive more care for UI than the general population.

Medicare Fee for Service claims data for women aged 66-91 years were compared for Nurses' Health Study participants (n = 3,213) and a propensity-matched sample from general Medicare Fee for Service beneficiaries (n = 3,213) with 1 or more outpatient evaluation and management visits for UI in 2012. We examined the mean number of outpatient visits for UI and the type of provider seen, using t tests and χ2 tests. Providers were categorized as specialist and nonspecialist providers using taxonomy codes.

The percentage of women 65 years or older who had an outpatient visits for UI over 12 months was 6.4% in the Nurses' Health Study cohort and 5.4% in the general population. The mean number of office visits for UI in 2012 was similar between nurses and the matched general population (mean = 1.8 vs 1.8; P = 0.3). A small percentage of women saw both nonspecialists and specialists for UI (9.3% in the Nurses' Health Study and 10.0% in the Center for Medicare Services cohorts).

We found that less than 7% of older women had outpatient evaluation of UI symptoms during a 12-month period, despite UI being very common in this age group. This was similar in nurses and the general population, suggesting that even high health care literacy does not increase UI care seeking.

Female pelvic medicine & reconstructive surgery. 2021 Jan 04 [Epub ahead of print]

Elisabeth Erekson, Giulia Lane, Jason Mann, Andrea Austin, Donald Carmichael, Vatche A Minassian, Francine Grodstein, Julie P W Bynum

From the Department of Obstetrics and Gynecology at Maine Medical Center, Portland, ME Department of Obstetrics and Gynecology at Tufts University School of Medicine, Boston, MA Department of Urology, University of Michigan Medical School Institute for Health Policy and Innovation, University of Michigan, Ann Arbor MI The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, Hanover, NH Division of Urogynecology, Department of Obstetrics and Gynecology at Brigham and Women's Hospital Channing Division of Network Medicine at Brigham and Women's Hospital, Harvard Medical School Department of Epidemiology at Harvard School of Public Health, Boston, MA Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.