The Quality of Care Provided to Women with Urinary Incontinence in 2 Clinical Settings.
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/m(2) 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.
['Anger|Jennifer T|JT|', 'Alas|Alexandriah|A|', 'Litwin|Mark S|MS|', 'Chu|Stephanie D|SD|', 'Bresee|Catherine|C|', 'Roth|Carol P|CP|', 'Rashid|Rezoana|R|', 'Shekelle|Paul|P|', 'Wenger|Neil S|NS|']
D019468:Disease Management D005081:Exercise Therapy D005240:Feasibility Studies D005260:Female D006801:Humans D008875:Middle Aged D010865:Pilot Projects D011320:Primary Health Care D019984:Quality Indicators, Health Care D011787:Quality of Health Care D014549:Urinary Incontinence
urinary incontinence female urogenital diseases quality indicators, health care quality of health care urinary bladder