Nocturnal Bladder Dysfunction: A Conceptual Framework Underlying Estimate of Cost

Abstract

Aim: Holistic care of geriatric inpatients involves bladder management at night. The aim of this study was to identify variables that should be included in a concept pool describing the attributable costs of nocturnal bladder dysfunction in the geriatric rehabilitation setting.Design: A scoping review to map the key contributors to cost of care in older people with nocturnal bladder symptoms during hospitalization was conducted using machine learning.Method: Individual and institution attributable cost factors implicated in the care for urinary tract symptoms at night during hospitalization, were identified and charted. A concept pool was developed and inter-relationships explored. Results:The two major health service consequences observed were incontinence-associated dermatitis and falls incidents. From an individual perspective, four health consequences emerged: stress, a fear of falling during the night, interrupted sleep and reduced quality of life. Limited mobility appeared as a contributor to nocturnal Lower Urinary Tract Symptoms (LUTSn), incontinence-associated dermatitis and falls. Conclusion:A conceptual framework of characteristics of affected individuals, alongside resource use and healthcare costs associated with bladder dysfunction at night, has been developed. This will provide a structure to evaluate the cost benefit of implementing improved care for older in-patients with LUTSn.