Incontinence costs

Incontinence contributes significantly to the cost of care in subacute care facilities such as rehabilitation and geriatric evaluation and management facilities according to a study published in the most recent edition of the Medical Journal of Australia.

Co-authors of the research, Ms Janette Green, Senior Research Fellow at the University of Wollongong; Ms Irenie Smoker, Health Economics Research Fellow at the University of New South Wales; Dr Tessa Ho, Health Service Researcher and Lecturer from the University of New South Wales; and Dr Kate Moore, Associate Professor of Obstetrics and Gynaecology at St George Hospital in Sydney; specifically examined the nursing and allied health care costs associated with incontinence.

Data on the continence status of 6,455 rehabilitation and geriatric in-patients in 54 medical facilities in Australia and New Zealand (over a three-month period in 1996) was derived from a dataset used by the Centre for Health Service Development, University of Wollongong, to develop a national casemix classification for subacute and non-acute care.

"The relationship between continence status and the cost of care is complex," said Janette Green, co-author of the study.

"The care of incontinent patients can require more staff time, extra laundry expenses, and additional items, such as catheters and continence pads," she said.

"Further costs arise because incontinent patients are often older and less functionally independent in other ways than continent patients with similar impairments.

"Orthopaedic and stroke patients accounted for over 50 per cent of impairment categories. Almost 50 per cent of orthopaedic patients and 65 per cent of stroke patients were incontinent.

"Continent patients had shorter stays in hospital and were more likely to be discharged to home. Incontinent patients were more likely to be discharged to a nursing home or further care.

"It is important that the difference in the cost of care and length of stay between continent and incontinent patients is reflected in payment systems," Ms Green said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

 CONTACT: Janette Green, 0422 687 392

Judith Tokley, AMA, 0408 824 306