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Urinary incontinence is common among residents of Southeastern nursing homes, especially among black residents

Over half of the three million elderly who receive care from nursing homes (NHs) are reported to suffer from urinary incontinence (UI), considered a key indicator of poor quality of care. Relatively little is known about differences in the prevalence of UI by race and region in the United States. However, a new study, supported in part by the Agency for Healthcare Research and Quality (HS13353), found that UI is common among residents of Southeastern nursing homes, and is even more common among black residents. The researchers analyzed data from the 1999-2002 Centers for Medicare & Medicaid Services Minimum Data Set, Atlanta Region, to investigate the prevalence of UI among black and white NH residents in the Southeast.

Most residents were white (82 percent) and female (77 percent). Regional UI prevalence was 65.4 percent at NH admission and 74.3 percent after admission. After NH admission, 73.5 percent of white and 78.1 percent of blacks were incontinent. Similarly, 72.2 percent of men and 75 percent of women were incontinent.

Admission prevalence of UI was greater than 50 percent in all eight States studied, with Mississippi having the lowest (56.1 percent) and South Carolina the highest (71.9 percent) prevalence. Black NH residents had higher rates of admission UI in all States. Blacks also had significantly higher odds of UI than whites after admission in Kentucky and Tennessee, but not in other States.

These racial differences in prevalence of UI indicate a lack of optimal care for blacks in the Southeastern region, note the researchers. The findings also highlight potential racial differences in access to care prior to NH entrance and differences in treatment options after NH admission. The researchers call for more studies to explore determinants of these racial differences.

See "Differences in resident characteristics and prevalence or urinary incontinence in nursing homes in the southeastern United States," by Josephine E. Boyington, Ph.D., M.P.H., R.N., Daniel L. Howard, Ph.D., Lori Carter-Edwards, Ph.D., M.P.H., and others, in the March 2007 Nursing Research 56(2), pp. 97-107.

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