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Neurourol Urodyn. 2005;24(1):56-62.

Costs of managing urinary and faecal incontinence in a sub-acute care facility: a "bottom-up" approach.

Author information

1
The Pelvic Floor Unit, St George Hospital, University of New South Wales, NSW, Australia.

Abstract

AIMS:

To measure accurately the direct costs of managing urinary and faecal incontinence in the sub-acute care setting.

MATERIALS AND METHODS:

Prospective observational study was undertaken in two sub-acute care units in a metropolitan hospital. A consecutive series of 29 consecutive patients with urinary and/or faecal incontinence, who were in-patients in a geriatric rehabilitation or sub-acute neurologic unit underwent routine timed voiding protocol, as per usual care. Face-to-face bedside recordings of all incontinence care, with detailed cost analysis, were undertaken.

RESULTS:

A total of 3,621 occasions of continence care were costed. The median time per 24 hr spent caring for incontinence per patient was 109 min (interquartile range 88-140). Isolated urinary incontinence episodes occurred in 28 patients (96.5%), mixed urinary/faecal incontinence episodes observed in 79.3%, and episodes of pure faecal incontinence were seen in 62%. The median costs of incontinence care in the sub-acute setting was $49AU per 24 hr, the major share ($41) spent on staff wages. The incontinence tasks of toileting assistance, pad changes, bed changes and catheter care were spread evenly across the three 8 hr shifts of duty.

CONCLUSIONS:

As our population demographics include an increasingly greater portion of the elderly, for whom long term institutional care is becoming relatively more scarce, provision of care in the sub-acute unit that may allow rehabilitation and return to home warrants scrutiny. This is the first study that delineates the costs of managing urinary and faecal incontinence in the sub-acute care setting. Such costs are substantial and place a heavy burden upon night-time carers.

PMID:
15573385
DOI:
10.1002/nau.20079
[Indexed for MEDLINE]

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