Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94115, USA.
Obstet Gynecol. 2012 Aug;120(2 Pt 1):277-83. doi: 10.1097/AOG.0b013e31825dd268.
To estimate the effect of a decrease in urinary incontinence (UI) frequency on UI management costs among women enrolled in a clinical trial of a weight loss intervention and to identify factors that predict change in cost.
This is a secondary cohort analysis of 338 obese and overweight women with 10 or more weekly episodes of UI enrolled in an 18-month randomized clinical trial of a weight loss intervention compared with a structured education program to treat UI. Quantities of resources used for incontinence management, including pads, additional laundry, and dry cleaning, were reported by participants. Direct costs for UI management ("cost") were calculated by multiplying resources used by national resource costs (in 2006 U.S. dollars). Randomized groups were combined to examine the effects of change in incontinence frequency on cost. Possible predictors of change in cost were examined using generalized estimating equations controlling for factors associated with change in cost in univariable analyses.
Mean age±standard deviation was 53±10 years and baseline weight was 97±17 kg. Mean weekly UI frequency was 24±18 at baseline and decreased by 37% at 6 months and 60% at 18 months' follow-up (both P<.001). At baseline, adjusted mean cost was $7.76±$14 per week, with costs increasing significantly with greater incontinence frequency. Mean cost decreased by 54% at 6 months and 81% at 18 months (both P<.001). In multivariable analyses, cost independently decreased by 23% for each decrease of seven UI episodes per week and 21% for each 5 kg of weight lost (P<.001 for both).
In obese and overweight women enrolled in a clinical trial of weight loss for UI, incontinence management cost decreased by 81% at 18 months ($327 per woman per year) and was strongly and independently associated with decreasing incontinence frequency.
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评估参加减肥干预临床试验的女性中尿失禁（UI）频率降低对 UI 管理成本的影响，并确定预测成本变化的因素。
这是一项对 338 名肥胖和超重女性的二次队列分析，这些女性每周有 10 次或更多次 UI 发作，参加了一项为期 18 个月的减肥干预随机临床试验，与治疗 UI 的结构化教育计划进行比较。参与者报告了用于失禁管理的资源量，包括垫、额外的洗衣和干洗。通过乘以使用的资源量乘以国家资源成本（2006 年以美元计）来计算 UI 管理的直接成本（“成本”）。将随机组结合起来，研究失禁频率变化对成本的影响。使用广义估计方程控制单变量分析中与成本变化相关的因素，来检查成本变化的可能预测因素。
平均年龄±标准差为 53±10 岁，基线体重为 97±17kg。基线时每周 UI 频率为 24±18，6 个月时下降 37%，18 个月时下降 60%（均 P<.001）。基线时，调整后的平均成本为每周$7.76±$14，随着失禁频率的增加，成本显著增加。6 个月时成本下降 54%，18 个月时成本下降 81%（均 P<.001）。多变量分析显示，每周 UI 发作减少 7 次，成本独立下降 23%，体重减轻 5kg，成本下降 21%（均 P<.001）。
在参加 UI 减肥临床试验的肥胖和超重女性中，18 个月时失禁管理成本下降 81%（每位女性每年 327 美元），与失禁频率的降低密切相关，且独立相关。
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