Teh wei Hu

Impact of Urinary Incontinence on Health-Care Costs

A 11 illness requires resources for diagnosis, treatment, and patient care. Urinary incontinence is no exception. Unlike cancer, heart ,disease, and AIDS, however, little is known about the impact of urinary incontinence on health-care costs. This is partly because incontinence is not a lifethreatening illness and thus society views it as an inconvenience rather than an illness, and partly because the medical-care-utilization data-collection system within the National Center for Health statistics does not have a special category for urinary incontinence. This article documents and estimates the magnitude of the impact of urinary incontinence on the cost of health care so that society in general can better recognize the hidden costs of urinary incontinence. Knowing the magnitude of the cost impact of urinary incontinence is important to the medical community in determining priorities for health-care services and research among various illnesses. The cost impact of urinary incontinence includes the overall effect on the allocation of resources at the societal as well as the institutional or individual level. Resources that come directly from the economy are used to diagnose, treat, care for, and rehabilitate incontinent individuals. The value of these resources is called the direct costs of incontinence and can be assessed directly from the market value of goods and services. These direct costs are the health-care costs referred to in this article. Indirect costs include the loss of work time during an incontinent individual’s physician visits or hospitalization, and/or the time spent by family members in caring for an incontinent individual. Indirect costs are assessed from opportunity costs or from the imputed value of resources. By

Profile of Urinary Incontinent Elderly in Long-Term Care Institutions

This article presents a profile of incontinent elderly in long‐term care institutions. One hundred thirty‐three frail elderly women were recruited from seven nursing homes in central Pennsylvania for a three‐year clinical trial to test the effectiveness of a behavioral therapy on urinary incontinence. All of the patients had more than one medical diagnosis. Eighty percent had cardiorespiratory conditions; the most prevalent diagnoses were cardiovascular diseases. Eighty percent had one or more neurological diseases, including “organic brain syndrome”(47%) and senile dementia (30%); 44% had arthritis/rheumatism. Half of the patients showed severe cognitive impairment; only 12% showed no cognitive impairment. Sixty‐three percent were totally dependent; 68% used wheelchairs, 61% were chairbound; 50% had impairments in vision, one‐third in hearing, and 14% in speech. Normal bladder capacity, absence of detrusor instability, and satisfactory bladder emptying, as evidenced by low residual urines, was found in 41% of the patients, suggesting that incontinence in this elderly group may not be a primary bladder problem, but rather that mental and physical disabilities may be a more important underlying cause of incontinence in these patients. An important finding in this study is that 34% of the patients had detrusor instability. It is theoretically possible that pharmacologic therapy with anticholinergic agents or imipramine could improve incontinence in this group. Five percent were found to have large residual urine volumes in association with high‐capacity bladders suggesting overflow incontinence as the cause of their daily leakage. Pelvic relaxation and stress leakage was far less common in this elderly group of nursing home patients than in young and middle‐aged women.

The ISQ-P Tool Measuring Stress Associated with Incontinence

1. ISQ-P is a useful tool in measuring psychological stress associated with urinary incontinence. 2. ISQ-P can be used in conjunction with bladder training programs. 3. Patients with urinary incontinence show depressive symptoms, have somatic concerns regarding urinary incontinence, and exhibit a feeling of shame.

The Cost-Effectiveness of DISPOSABLE VERSUS REUSABLE DIAPERS A Controlled Experiment in a Nursing Home

Because caring for incontinent elderly in nursing homes is so time-consuming and costly, this topic is of interest to nursing home administrators. A comparison of disposable products with reusable cloth diapers suggests that the disposable product used in the controlled study could save nursing homes approximately

Urinary Incontinence : Nursing Home Staff Reaction Toward Residents

161 to

A Clinical Trial of a Behavioral Therapy to Reduce Urinary Incontinence in Nursing Homes: Outcome and Implications

248 per year per person. Although product costs were similar, the cost savings on laundry favored the disposable product. The study found the disposable product superior to the cloth reusable diaper after the skin condition of the participants was measured.

Incontinence products: Which is best?

1. ISQ-SR is a reliable and valid tool to measure psychological stress associated with working with urinary incontinent patients. 2. ISQ-SR can be used to measure efficacy of continuing education programs aimed at reducing staff stress associated with urinary incontinence. 3. Eighty percent of the staff reported that they looked for ways to help patients with their incontinence all the time, but only 50% said that they felt comfortable working with urinary incontinent patients all of the time. 4. Sixty-three percent of the staff reported that they felt frustrated about working with urinary incontinence some of the time, indicating a need for continuing education.