Gender differences in healthcare-seeking behavior for urinary incontinence and the impact of socioeconomic status: a study of the Medicare managed care population.

BACKGROUND: Despite the gender difference in etiology, prevalence and management of urinary incontinence (UI) among community-living older adults, little is known about the effect of gender on their healthcare-seeking behaviors.
OBJECTIVE: To determine gender differences in professional care seeking, receipt of UI treatment, and the impact of age and socioeconomic status. RESEARCH
DESIGN: National survey of Medicare managed care enrollees in 2003 and 2004.
SUBJECTS: A total of 28,724 patients who were noninstitutionalized, age 65 and older, and had self-reported UI problem in the last 6 months. MEASURES: Whether a patient with UI had discussed the problem with a health provider, and whether a patient having had such a discussion received treatment.
RESULTS: Compared with incontinent men, incontinent women were less likely to seek professional help for the UI problem [46.2% vs. 55.7%; adjusted odds-ratio (AOR) = 0.65, P < 0.01], but more likely to receive treatment (54.8% vs. 51.4%; AOR = 1.12, P < 0.01) after consulting a health professional. These gender differences varied by age, education, or annual household income level. For incontinent women, the predicted rate of receiving treatment decreased with older age, lower education, and lower income level.
CONCLUSIONS: Community-living older women with UI problem are less likely to seek professional help than their male counterparts, but more likely to be treated after a health professional is consulted. Patients' socioeconomic status can affect physician behavior and ultimately, their receipt of treatment of UI, especially for women. Current efforts to promote awareness and quality-of-care of UI among older adults should account for gender and other sociodemographic factors.