Mp23-06 Geographical Variation in Treatment of Stress Urinary Incontinence in the United States

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence (MP23)1 May 2024MP23-06 GEOGRAPHICAL VARIATION IN TREATMENT OF STRESS URINARY INCONTINENCE IN THE UNITED STATES Kelly Ieong, Tal Cohen, Zhenyue Huang, Wai Lee, Jason Kim, and Justina Tam Kelly IeongKelly Ieong , Tal CohenTal Cohen , Zhenyue HuangZhenyue Huang , Wai LeeWai Lee , Jason KimJason Kim , and Justina TamJustina Tam View All Author Informationhttps://doi.org/10.1097/01.JU.0001008776.99097.8a.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Geographical variation in healthcare utilization and costs have been well documented as healthcare disparities. Prior studies have noted inequitable access to incontinence care across different age groups and socioeconomic backgrounds. Treatment options for stress urinary incontinence (SUI) include midurethral sling and urethral bulking. The objective of this study is to describe the nationwide variations in SUI treatment. METHODS: The Medicare Provider Utilization and Payment Data was queried from 2013 to 2019. This is a large, US-based database that provides claims data for Medicare beneficiaries. Reimbursements associated with CPT codes 51715 (endoscopic injection of implant material into urethra) and 57288 (sling operation for SUI) were used to identify SUI procedures. The total number of procedures were summed across the years for each state. Geographical rate per capita was calculated. States with the highest and lowest utilization rate were identified. The trend of procedures performed between 2013 and 2019 was identified. Geographical variations were evaluated using extremal quotient (EQ) and coefficient of variation (CV). RESULTS: Nebraska, Kansas, Oklahoma and Maryland had the highest utilization rates in both urethral bulking and sling placement. New Mexico, Wyoming, Minnesota and West Virginia had the lowest utilization rates in both urethral bulking and sling placement. The highest and lowest utilization states for urethral bulking and sling placement are mapped in Figure 1. From 2013 to 2019, only 2 states had an increased rate of urethral bulking: Washington and Nebraska. 24 states had an increased rate of sling placement from 2013 to 2019. Montana and West Virginia had the highest rate of increase in sling procedures (5.8% and 3.8%, respectively). The EQ was 54.6 for bulking and 77.3 for sling placement, indicating a fifty and seventy-fold difference between the highest and lowest states. The CV was 64.7 for bulking and 128.1 for sling, indicating a very high variation. CONCLUSIONS: There is a marked geographical variation in SUI treatment rates. With the introduction of the new urethral bulking agent in 2020, further changes in utilization rates may occur. Future studies evaluating the number of providers who are able to perform these procedures may help to understand this geographical discrepancy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e383 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kelly Ieong More articles by this author Tal Cohen More articles by this author Zhenyue Huang More articles by this author Wai Lee More articles by this author Jason Kim More articles by this author Justina Tam More articles by this author Expand All Advertisement PDF downloadLoading ...