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Impact of urinary incontinence on medical rehabilitation inpatients
Author(s) -
Mallinson Trudy,
Fitzgerald Colleen M.,
Neville Cynthia E.,
Almagor Orit,
Manheim Larry,
Deutsch Anne,
Heinemann Allen
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22908
Subject(s) - medicine , rehabilitation , urinary incontinence , orthopedic surgery , demographics , physical therapy , retrospective cohort study , cohort , acute care , cohort study , emergency medicine , health care , surgery , demography , sociology , economic growth , economics
Aims To determine the prevalence of urinary incontinence (UI) and its association with rehabilitation outcomes in patients receiving inpatient medical rehabilitation in the United States. Methods A retrospective, cohort study of 425,547 Medicare patients discharged from inpatient rehabilitation facilities (IRFs) in 2005. We examined prevalence of UI at admission and discharge for 5 impairment groups. We examined the impact of demographics, health, and functional status on the primary outcome, change in continence status, and secondary outcomes of discharge location and 6‐month mortality. Results Approximately one‐quarter (26.6%) of men were incontinent at admission compared to 22.2% of women. In all diagnostic groups, continence status remains largely unchanged from admission to discharge. Patients who are older, have cognitive difficulties, less functional improvement, and longer lengths of stay (LOS), are more likely to remain incontinent, compared to those who improved, after controlling for patient factors and clinical variables. UI was significantly associated with discharge to another post‐acute setting (PAC). For orthopedic patients, UI was associated with a 71% increase in the likelihood of discharge to an institutional setting after controlling for patient factors and clinical variables. UI was not associated with death at 6 months post‐discharge. Conclusions UI is highly prevalent in IRF patients and is associated with increased likelihood of discharge to institutional care, particularly for orthopedic patients. Greater attention to identifying and treating UI in IRF patients may reduce medical expenditures and improve other outcomes. Neurourol. Urodynam. 36:176–183, 2017 . © 2015 Wiley Periodicals, Inc.