Costs of managing urinary and faecal incontinence in a sub‐acute care facility: A “bottom‐up” approach

Morris, Alastair R.; Ho, Maria; Lapsley, Helen; Walsh, Joan; Gonski, Peter; Moore, Kate H.

doi:10.1002/nau.20079

Cited by 26 publications

(32 citation statements)

References 12 publications

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“…This included 13.3% of staff time spent purely on managing incontinence. 42 From this study it can be seen that the actual costs caused by incontinence are likely to be even larger than those quoted earlier in the present paper. Information about costs in the wider community using a 'bottom-up' approach, particularly when indirect and intangible costs are added, is likely to show that the costs of incontinence present a very large burden on the Australian community.…”

Section: The Community Cost Of Incontinencecontrasting

confidence: 51%

“…The authors are very grateful to Dr Maria Theresa (Tessa) Ho at the Health Economics Unit, School of Public Health and Community Medicine, University of New South Wales for advice on community costs of incontinence 42 .…”

Section: Acknowledgementsmentioning

confidence: 99%

“…The study used a 'bottom-up' approach that examines patients directly, recording and costing episodes of incontinence. 42 The detailed study was carried out on all patients admitted to a Sydney metropolitan hospital for subacute care more than a 48-h period. The additional costs incurred, including those from nursing and time spent by other staff specifically to manage incontinence, disposables, and linen change were calculated, and amounted to $A49 per day per patient.…”

Section: The Community Cost Of Incontinencementioning

confidence: 99%

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Obstetric‐induced incontinence: A black hole of preventable morbidity

Thornton

Lubowski

2006

Aust NZ J Obst Gynaeco

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There is a detailed literature comprising clinical and anorectal physiological studies linking faecal incontinence to vaginal delivery. Specific risk factors are high infant birthweight, forceps delivery and prolonged second stage of labour. The onset of symptoms may be delayed for many years. Faecal incontinence occurs in more than 10% of adult females and urinary incontinence in about a third of multiparous women. This places a very large economic burden on the Australian health system. A conservative estimate for overall management of incontinence would be in excess of $A700 million but the actual amount is unknown. Preventative measures for avoiding pelvic floor injuries need to be established, and safe obstetric practice needs to be redefined in the light of current knowledge about incontinence. Outcome measures for safe birthing should not only include infant and maternal mortality and infant morbidity, but should also include the long-term effects of vaginal delivery on the pelvic floor, particularly urinary and faecal incontinence. Several state reports and one federal senate report on safe birthing have been lacking in this area. The safety of birthing centres and home birthing needs to be examined to provide birthing mothers with complete and appropriate information about safety in order that they may consider their options. Appropriate Caesarean section rates for optimal birthing safety are unknown and need to be re-examined. Calls for overall reduction in Caesarean section rates in Australia are inappropriate and cannot be justified until the effects of pelvic floor injury are added to the overall assessment.

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Section: The Community Cost Of Incontinencecontrasting

confidence: 51%

Section: Acknowledgementsmentioning

confidence: 99%

Section: The Community Cost Of Incontinencementioning

confidence: 99%

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Obstetric‐induced incontinence: A black hole of preventable morbidity

Thornton

Lubowski

2006

Aust NZ J Obst Gynaeco

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“…Patients with UI who require absorbent products require higher levels of assistance than do continent patients. 3 For example, patients managed in a long-term acute care facility required an average of 109 min/d for continence care, translating into a total cost of €31.30 per patient per day. The intangible costs for patients with UI, thought to be substantial, are unknown.…”

Section: ■ Introductionmentioning

confidence: 99%

The Effects of a Multi-intervention Incontinence Care Program on Clinical, Economic, and Environmental Outcomes

Palese

Carniel

2011

Journal of Wound, Ostomy &Amp; Continence Nursing

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“…Five studies11 16 18 19 21 utilised less than 50 patients (range 1–42); only two studies17 20 utilised >100 patients.…”

Section: Methodsmentioning

confidence: 99%

Effective management of acute faecal incontinence in hospital: review of continence management systems

Ousey

Gillibrand

Lui

2010

Frontline Gastroenterol

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REVIEWThis paper reviews the scientifi c literature regarding current systems available for the management of acute faecal incontinence (FI) in hospital patients. The review searched Medline from 1950 to October 2009 using the adapted search strategy, as devised by the Cochrane Incontinence Group, in order to identify studies relevant to this review, yielding 197 records. Ten studies fi tted the inclusion criteria with none of the studies being randomised control trials. Characteristics identifi ed from the studies included: duration of the management devices, cost implications, length of patient stay, contraindications and patient assessment. The management of acute FI in acute settings is a relatively ignored problem, with little available evidence to support a standardised approach to its management. The review highlights the need for early identifi cation of contraindications when FI management systems are being used, particularly in patients administered antithrombotic drugs such as aspirin. IntroductionThe management of acute faecal incontinence (FI) in acute settings is a relatively ignored problem, with little available evidence to support a standardised approach to its management. 1 2 FI is defined as the inability to control gas or stools, ranging from mild difficulty with gas control to complete loss of control over liquid and formed stools.3 This could be debilitating and intensely embarrassing to those affected and in many cases it has a profound impact on the patient's quality of life, 4 outcomes and their dignity. FI could be caused by differing aetiology or artificially induced through paralysis. Although medically derived interventions are used to deal with FI, including drug therapy, it is often nursing practice which provides direct patient care and management. 5-8FI has been explored from the perspective of chronic conditions with associated aetiology of a variety of disorders.4 Prevalence data are difficult to determine from the chronic perspective, as it relies on patient self-reporting, and as patients with FI suffer embarrassment, shame and depression, it is often under-reported. 9 Other epidemiological studies have reported varying prevalence due to different populations sampled, differences in data collection and no standard definition. 4 Reported prevalence ranges from 4.4% 10 in the community population to 18.4% in outpatient settings. 9 In the UK, the Department of Health estimated that in institutional care, the prevalence of regular FI is as high as 25%. 6FI in hospital patients is often the result of multiple factors, or the result of another treatment that cannot be discontinued.11 FI is one of the associated problems with prolonged immobilisation, especially among the elderly and critically ill. Nursing care of bedridden patients with FI is more labour intensive and increases the risk of perianal wound infection.12 Indeed, FI related problems have the potential to influence length of stay in hospital, gaining hospital infections and increasing the amount of nursing interventions...

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Costs of managing urinary and faecal incontinence in a sub‐acute care facility: A “bottom‐up” approach

Cited by 26 publications

References 12 publications

Obstetric‐induced incontinence: A black hole of preventable morbidity

Obstetric‐induced incontinence: A black hole of preventable morbidity

The Effects of a Multi-intervention Incontinence Care Program on Clinical, Economic, and Environmental Outcomes

Effective management of acute faecal incontinence in hospital: review of continence management systems

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