Clinical guidelines and cost implications — the case of stress urinary incontinence

Abstract

One goal of the Agency of Health Care Policy and Research (AHCPR) is to improve the quality of medical care by developing and disseminating clinical practice guidelines. An indication of the effectiveness of a clinical guideline is the relationship between the medical benefits gained and the costs of achieving those benefits when the guideline is implemented. Using outpatient and inpatient claims data, this paper reports the current practice patterns, cost variations, and cost implications of implementing a proposed clinical guideline for stress urinary incontinence. The current practice patterns reveal large practice variations for incontinence care, with many basic procedures infrequently used. If the clinical guideline for stress incontinence is implemented as designed, the authors project a total annual cost savings of roughly $36 million in 1992 dollars in the United States.