Urinary catheterization from 1997 to 2018: a Dutch population-based cohort

Abstract

Background: Our aim was to evaluate the use of indwelling, intermittent and external urinary catheters in neurogenic and non-neurogenic bladder patients in the Netherlands from 1997 to 2018. Methods: Data were retrieved from a population-based cohort containing information about the extramural use of medical devices in the insured population in the Netherlands. The insured population increased from 9.9 million people in 1997 to 17.1 million people in 2018 (64–100% of the Dutch population). Users are expressed by users per 100,000 insured people and total users, corrected for the overall Dutch population. The expenditures are corrected for inflation and expressed by total costs and costs per user. Results: During this 21-year period, indwelling catheter (IC) users doubled from 159 per 100,000 people (24,734 users) to 315 per 100,000 people (54,106 users). Clean intermittent catheter (CIC) users increased from 92 per 100,000 people (14,258 users) in 1997 to 267 per 100,000 people (45,909 users) in 2018. Of all users, 20.7% had an associated neurogenic disorder and 44.9% a non-neurogenic disorder in 2018. The total expenditure on extramural use of urinary catheters increased from 27.7 million euros in 1997 to 84.4 million euros in 2018. IC costs increased from 6.0 million euros in 1997 to 6.7 million euros in 2018, while CIC costs rose from 16.4 million euros to 74.6 million euros. Urine drainage bag costs decreased from 17.2 million in 2001 to 5.3 million in 2018. Conclusions: IC use has increased substantially over the past 21 years, despite the fact that CIC use increased as well. It seems that the main driver behind the prevalence in IC and CIC use, is the rise in incontinence care in older patients and the adaption of preferred CIC use in professional guidelines. At least one fifth of all users catheterize due to neurogenic reasons.

Regional variation in urinary catheter use in the Netherlands from 2012 to 2021: a population-based cohort

“…This is consistent with our two previous studies that evaluated the use of urinary catheters in the Netherlands with an overlapping cohort from 1997 to 2018. 11,12 They found that the number of CIC users tripled and the number of IDC users doubled over two decades. Moreover, they found an increase in CIC and IDC use in the younger age categories, which may be a result of exponential population growth, among other factors.…”

Single use versus reusable catheters in intermittent catheterisation for treatment of urinary retention: a protocol for a multicentre, prospective, randomised controlled, non-inferiority trial (COMPaRE)

“… 7 Extremely high in comparison to the expenditure of indwelling catheters in the Dutch outpatient setting (only 6,7 million euro for 54 000 users). 42 Almost 25% of the users had a neurogenic underlying disease, which are usually chronic users with multiple 4–6 catheterisations per day. Based on this assumption, the amount of disposable catheters used on an annual basis for users with a neurogenic underlying disease is more than 20 million disposable catheters a year.…”

Effective Treatments of UTI—Is Intravesical Therapy the Future?

“…A National Health Service England survey from across the entire system of its users found 12.9% of patients were catheterised [ 6 ]. Similarly, a Dutch survey revealed that over a 21-year period (1997–2018), indwelling catheter use per 100,000 population nearly doubled and intermittent catheter usage nearly trebled [ 7 ]. In the US, America’s Medicare & Medicaid reimburse up to 200 intermittent catheters/month/per person, encouraging single use only to minimise infections [ 8 ].…”