Objectives: To test the feasibility of obtaining a baseline level of quality of reporting for cost-utility analysis (CUA) studies using the British Medical Journal economic submissions checklist, test interrater reliability of this tool, and discuss its longer term implications.Methods: CUA studies in peer-reviewed English language journals in 1996, assessed using the British Medical Journal checklist, a quality index, and interrater reliability correlations.Results: Forty-three CUA studies were assessed, with 23 checklist items acceptable and 10 items inadequate. Lowest quality scores were reported in specialist medical journals. Proportional agreement between assessors was over 80%.Conclusions: The British Medical Journal checklist is a feasible tool to collect baseline information on the quality of reporting in journals other than the British Medical Journal. Editors of specialist medical journals are in greatest need of economic guidance. If handled carefully, they might consider adopting the British Medical Journal checklist.

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Objective: To investigate the effect of incontinence on clinical outcomes and costs for patients in subacute care. Design: Retrospective analysis of data collected over a 3‐month period in 1996. Setting: 54 medical facilities in Australia and New Zealand providing subacute care in an inpatient setting. Patients: 6773 episodes of care provided to 6455 rehabilitation and geriatric evaluation and management patients. Main outcome measures: Urinary continence status, treatment outcomes, length of stay, discharge destination, and nursing and allied healthcare costs. Results: Discharge destination differed between incontinent and continent patients (57% compared with 82%, respectively, discharged home, and 29% compared with 12%, respectively, discharged to a nursing home or to further care). There was a difference in cost between patients who were continent and those who were incontinent throughout their episode of care (rehabilitation: $185.60 [95% CI, $181–$190] per day for incontinent and $156.82 [95% CI, $153–$160] for continent patients; and geriatric evaluation and management: $164.62 [95% CI, $157–$172] for incontinent and $121.40 [95% CI, $114–$129] for continent patients). However, multilevel analyses showed that, after allowing for age and level of functional independence, the contribution of continence status to the cost of care depended on the functional independence of the patient (cognitive function for orthopaedic patients [P < 0.01] and motor function for stroke patients [P = 0.04]). Conclusion: The relationship between continence status and cost of care is complex. However, the cost differences found in our study need to be considered in payment systems, allocation of staff levels on wards and in development of casemix classifications.