OBJECTIVES

Patients who perform intermittent catheterization (IC) may have an increase in preventable healthcare utilization. This study investigated the impact of a patient support program on use of emergency room (ER) and hospital overnight (HL) stays in the first month following initiation of IC for urological conditions.

METHODS

An online survey was designed to evaluate the impact of a patient support program (Coloplast® Care, Coloplast Corp. Minneapolis, MN). Eligible persons (≥18 years and with an e-mail address available in a database of IC users) willing to participate in the survey were provided access to a SurveyMonkey URL. Outcomes of interest included ER visits and HL stays in the first month following initiation of IC. Zero-inflated poisson regression was used for ER visits; zero-inflated negative binomial regression was used for HL stays due to overdispersion in that variable. Significance was determined at the p<.05 level.

RESULTS

Analysis included 321 current IC users in the patient care program; and 124 non-program IC users. Among program enrollees the mean age was 69 years, 79% male, 51% <bachelor's degree, and 99% had health insurance. For non-enrollees the mean age was 67 years, 89% male, 40% <bachelor’s degree, and 97% had health insurance. Reported medical conditions were similar between groups. Compared to non-enrolled, the enrolled group was associated with a 47% decrease in ER visits (adjusted rate ratio: 0.53; p-value=0.036), and a 77% decrease (adjusted rate ratio: 0.23; p-value=0.002) in HL stays within the first month of IC, when controlling for age, gender, education, region, insurance status, time to the start of using IC, and medical conditions.

CONCLUSIONS

The patient support program was associated with statistically significant reductions in both ER visits and HL stays within the first month after start of using IC. Adjusted for confounders enrolled users had 47% fewer ER visits and 77% fewer HL.