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Incontinence in institutions: costs and contributing factors
1Division of Geriatric Medicine, University of Western Ontario, London.
Objectives:
To determine the relative independent contributions of mobility and mental function to the prevalence rate of incontinence in a long-term care hospital and to establish the baseline prevalence rate and cost of incontinence before implementation of a continence program.
Design:
Prevalence survey.
Setting:
Long-term care hospital.
Participants:
All 457 inpatients (mean age of men 73.6 years, of women 73.8 years) who met the defined criteria for degree of urinary and fecal incontinence, mobility and mental function. Of the 447 questionnaires that were returned 12 were incomplete.
Main Outcome Measures:
Degree of urinary and fecal incontinence and costs of incontinence as measured by nursing time spent dealing with incontinent patients, laundry and incontinence supplies.
Results:
The prevalence rate of urinary incontinence was 62%, fecal incontinence 46% and combined incontinence 44%. The mean time spent each day dealing with incontinence was 52.5 minutes per patient. The total annual cost of incontinence per patient was $9771. Mobility and mental function were independent predictors of frequency of urinary and fecal incontinence. Frequency of incontinent events was the strongest predictor of quantity of linen soiled, but immobility was the strongest predictor of nursing time spent dealing with incontinence.
Conclusions:
The prevalence rate of urinary incontinence depends on patient characteristics and the definition of incontinence. A management approach to incontinence could lower laundry and supply costs, and improvements in mobility could reduce nursing time spent dealing with incontinence.