The Quality of Care Provided to Women with Urinary Incontinence in 2 Clinical Settings

Jennifer T. Anger, Alexandriah Alas, Mark S. Litwin, Stephanie D. Chu, Catherine Bresee, Carol P. Roth, Rezoana Rashid, Paul Shekelle, Neil S. Wenger

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose Our aim was to test the feasibility of a set of quality of care indicators for urinary incontinence and at the same time measure the care provided to women with urinary incontinence in 2 clinical settings. Materials and Methods This was a pilot test of a set of quality of care indicators. A total of 20 quality of care indicators were previously developed using the RAND Appropriateness Method. These quality of care indicators were used to measure care received for 137 women with a urinary incontinence diagnosis in a 120-physician hospital based multispecialty medical group. We also performed an abstraction of 146 patient records from primary care offices in Southern California. These charts were previously used as part of ACOVE (Assessing Care of Vulnerable Elders Project). As a post-hoc secondary analysis, the 2 populations were compared with respect to quality, as measured by compliance with the quality of care indicators. Results In the ACOVE population, 37.7% of patients with urinary incontinence underwent a pelvic examination vs 97.8% in the multispecialty medical group. Only 15.6% of cases in the multispecialty medical group and 14.2% in ACOVE (p = 0.86) had documentation that pelvic floor exercises were offered. Relatively few women with a body mass index of greater than 25 kg/m2 were counseled about weight loss in either population (20.9% multispecialty medical group vs 26.1% ACOVE, p = 0.76). For women undergoing sling surgery, documentation of counseling about risks was lacking and only 9.3% of eligible cases (multispecialty medical group only) had documentation of the risks of mesh. Conclusions Quality of care indicators are a feasible means to measure the care provided to women with urinary incontinence. Care varied by population studied and yet deficiencies in care were prevalent in both patient populations studied.

Original languageEnglish (US)
Pages (from-to)1196-1200
Number of pages5
JournalJournal of Urology
Volume196
Issue number4
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

Keywords

  • female urogenital diseases
  • quality indicators, health care
  • quality of health care
  • urinary bladder
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

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