Establishing the nature of the cost of incontinence care in a home care population: implications for nursing practise and health services

Abstract

Objective: To determine the cost of incontinence in three Home Care Programs. Design: Incontinent patients were identified by survey. Retrospective review of thesepatients' charts was conducted to determine the frequency of nursing and home-making visits as well as the volume of incontinence product used by each patient. Setting: The study population was drawn from three contiguous regional government-funded Home Care Programs in southern Ontario. All patients receiving nursing services at study inception were included. Participants: One hundred and seventy-three visiting nurses from the three Home Care Programs (HCPs) completed surveys on their incontinent patients in May 1996. Main outcome measures: A survey questionnaire was completed by the visiting nurse foreach incontinent patient. The calculation of the total cost of incontinence was based on the nursing and home-making time related to incontinence care activities, as well as incontinence product provided by the HCPs. Findings: The survey identified that in May 1996, 705 (5.3%) of the patients in the threeHCPs were incontinent. The total cost of incontinence for the 705 patients was $1.9 million. The major part of this cost was home-making time (47%) followed by nursing time (42%). Incontinence products accounted for only 11% of the direct cost of incontinence care. Conclusions: Study results demonstrate that the real cost of incontinence care tocommunity HCPs is comprised not just of provision of product but also of nursing and home-making services. The cost of incontinence products is a minor source of cost. Efforts to reduce cost need to focus on the assessment and management of incontinence. In order to do this the awareness of health care providers and the public needs to be raised to the potential treatment options and resources available to manage or resolve incontinence.