Continuous Improvement and the Expansion of Quality ... - NCQA

T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • H E D I S M E A S U R E S o f C A R E
MANAGEMENT of URINARy INCoNTINENCE
IN olDER ADUlTS
Urinary incontinence (UI) is involuntary loss of urine. 1,2 It is largely underestimated because
fewer than half of affected patients report it to their providers, partly because it is believed to
be an inevitable part of aging. 3 In the older population, UI is the result of several factors that
include comorbid conditions, multiple medications and functional and cognitive impairment. 1 The
Management of Urinary Incontinence in Older Adults measure assesses whether adults over the
age of 65 were asked about UI symptoms and received appropriate treatment.
• UI prevalence increases with age and is
a major cause of admittance to nursing
homes. It is more common in older
women—its prevalence in older men is
approximately one-third that of women. 1
• Many studies report that females with UI
seek help in very low percentages (ranging
from 14 percent–38 percent). Another
study found that 74 percent of women with
UI symptoms waited for one year before
seeking help, and 46 percent waited for
three years. 4,5
the Case for Improvement
• The estimated total annual cost of UI
is about $32 billion, or approximately
$3,565 per individual with UI. The largest
components are management costs and
expenses associated with nursing home
admissions attributable to UI. 7
• Given a rapidly aging population, the
incidence and prevalence of UI continues to
be a major problem. Among homebound
elderly, the incidence of UI is 15 percent–
33 percent. 5,6
• UI further puts older adults at risk for falls,
fractions and functional impairment. It is
associated with poor self-rated health,
impaired quality of life, social isolation,
depressive symptoms and dependence on
caregivers. 8
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HEdIs Measure definition
This patient survey measure assesses the
diagnosis and management of UI in older adults.
• Discussing UI. The percentage of Medicare
adults 65 and older who reported having a
problem with urine leakage in the past six
months and discussed their problem with
their current practitioner.
• Receiving UI Treatment. The percentage
of Medicare adults 65 and older who
reported having a urine leakage problem
in the past six months and received
treatment for their current urine leakage
problem.
M E A S U R E S T A R G E T E D A T o l D E R A D U l T S