Abstract :
Purpose and Relevance: Urinary incontinence is a common but under reported health condition, especially among women across the world. Data from various studies among Indian women suggest prevalence between 19% and 46%. International consultation on Incontinence (2018) recommends physiotherapy interventions as one of the first line of management. Data from an 800 bed tertiary care medical college hospital suggest limited utilisation of physiotherapy services for incontinence (one referral/month). Multiple barriers exist and needs a unified health systems approach to improve access to care. The present study, using hospital outpatient data, aimed to determine the potential for referrals to physiotherapy for management of urinary incontinence.
Participants: Women above the age of 18 years and visiting any of the OPDs of the hospital were considered eligible to be included in the analysis.
Materials and Methods: Using a retrospective design, the study analysed hospital out-patient statistics for a three- month period. After due administrative permission, details of adult women visiting the OPDs were obtained from the hospital IT department and categorised as per all department; high potential department (Urology & OBG); and Physiotherapy. Using national prevalence studies, potential burden of urinary incontinence among the women visiting the OPDs was estimated and a projection for potential for referral was made.
Results: During the three-month period, a total of 26546, 5371 and 271 adult women (36±21 years) visited OPDs of all departments, high potential departments and physiotherapy department respectively. If there existed a clinical care pathway to screen for urinary incontinence among all adult women visiting the hospital; even at a conservative estimate of 25% prevalence and screening of 50% women, about 5309, 1074 and 54 women from all departments, high potential departments and physiotherapy department respectively could have been identified to have had incontinence.
Conclusion: There is an extensive gap between potential for referrals and current practice. Creating awareness among the key stake holders is recommended.
Implications: There is a strong need for developing and implementing appropriate clinical care pathways to improve access to physiotherapy services for incontinence.
Keyword :
Clinical care Pathways, Urinary incontinence, Pelvic floor muscle training, Healthcare access, Barriers