OBJECTIVES: Most people with spinal cord injury (SCI) empty their bladder by way of catheterization. It is well-established that catheterization causes urinary tract infections (UTI). Amongst bladder catheterization methods, intermittent catheterization (IC) is today accepted as having the lowest risk for UTI and is considered as the gold standard for bladder emptying. The objective of this study was to use a claims-database to describe the burden of illness in terms of UTI occurrence and cost in people with SCI performing IC (SCI-IC).

METHODS: An anonymized dataset (year 2007- 2015) including 2.5m beneficiaries from a subset of German statutory health care insurance companies was used. ICD-codes identified people who had suffered an injury before 2015; the outcome analysis was based on those people who had IC product claims in at least two quarters of 2015. The control group consisted of a random sample of beneficiaries, matched 1:50 on gender and age (tolerance ±1 year).

RESULTS: 153 SCI-IC were identified. Compared to controls, the SCI-IC group displayed, on a yearly basis, a significantly higher UTI prevalence (6%; 59% p<0.05), UTI incidence rate (0.1; 2.2, p<0.05), sick leave due to UTI (1%; 25%, p<0.05) and a higher outpatient usage of unspecified antibiotics (prevalence 26%; 69%, p<0.05). Health care costs were approximately 9 times higher in the SCI-IC group (mean annual costs €2,457; €21,544, p<0.05).

CONCLUSIONS: Data from German health care insurance companies can be used to describe the burden of illness by confirming that SCI-IC are significantly burdened by UTIs when compare to matched, non-catheterizing controls.