Burden of illness the first year after diagnosed bladder dysfunction among people with spinal cord injury or multiple sclerosis – a Danish register study

ABSTRACT

Background

People with spinal cord injury (SCI) or multiple sclerosis (MS) are often living with some degree of bladder and/or bowel dysfunction due to acquired neurogenic damage. The objective was to estimate the burden of illness of SCI and MS the first year after diagnosed bladder dysfunction.

Methods

Data were extracted from registers covering all Danish citizens. People with SCI or MS were indexed at diagnosis of bladder dysfunction. Inclusion period was 2002–2015 and cases and matched controls were followed for one year.

Results

A total of 2,132 subjects with SCI and 1,887 subjects with MS were identified. Healthcare utilization and societal costs per patient-year were significantly higher for cases compared to controls driven primarily by inpatient care. Cases with urinary tract infection had significantly higher inpatient costs per patient-year compared to controls (SCI: 544 EUR vs 23, p < 0.05; MS: 497 EUR vs 6, p< 0.05) and medication for constipation was significantly more costly per patient-year (SCI: 178 EUR vs 3, p < 0.05; MS: 78 vs 1, p < 0.05).

Conclusions

The study demonstrates heavy societal and personal costs in the first year after bladder dysfunction in people with SCI or MS. This emphasizes the need for medical and social interventions to reduce the burden of illness.

KEYWORDS:

• Cost of illness
• healthcare costs
• multiple sclerosis
• neurogenic bladder
• societal costs
• spinal cord injury
• urinary tract infection

Acknowledgments

Writing support was provided by Malene Bagger, employed by M Bagger Scientific Writing, which is an independent medical writing agency. The writing support was funded by Coloplast.

Author contributions

M Lynge Buchter and C Sternhufvud were involved in study design, interpretation and discussion of results, appropriate presentation of results, and revising the manuscript. J Kjellberg and R Ibsen contributed to study design, data collection and the processing and statistical handling of the data to generate the results, verified the underlying data and validated results, as well as editorial support. B Petersen provided clinical input, was involved in study design, interpretation and discussion of results, presentation of results, and revising the manuscript. All authors read the final version of the manuscript critically and approved the final version to be published.

Declaration of interest

M Lynge Buchter is an employee of Coloplast AS/, Denmark. J Kjellberg is employed by VIVE, the Danish Center for Social Science Research, Denmark, an independent research and analysis centre. VIVE received funding from Coloplast for the contribution to this study. R Ibsen is an employee of i2Minds, an independent data analysis agency, which received funding from VIVE to this study. C Sternhufvud is an employee of Coloplast AB, Sweden. B Petersen is employed by MedDevHealth, Denmark, an independent consultancy, and received funding from Coloplast for the contribution to the study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed here

Additional information

Funding

This study was funded by Coloplast.