Urinary incontinence in subacute care--a retrospective analysis of clinical outcomes and costs
Abstract
OBJECTIVE: To investigate the effect of incontinence on clinical outcomes and costs for patients in subacute care.
DESIGN: Retrospective analysis of data collected over a 3-month period in 1996.
SETTING: 54 medical facilities in Australia and New Zealand providing subacute care in an inpatient setting.
PATIENTS: 6773 episodes of care provided to 6455 rehabilitation and geriatric evaluation and management patients.
MAIN OUTCOME MEASURES: Urinary continence status, treatment outcomes, length of stay, discharge destination, and nursing and allied healthcare costs.
RESULTS: Discharge destination differed between incontinent and continent patients (57% compared with 82%, respectively, discharged home, and 29% compared with 12%, respectively, discharged to a nursing home or to further care). There was a difference in cost between patients who were continent and those who were incontinent throughout their episode of care (rehabilitation: $185.60 [95% CI, $181-$190] per day for incontinent and $156.82 [95% CI, $153-$160] for continent patients; and geriatric evaluation and management: $164.62 [95% CI, $157-$172] for incontinent and $121.40 [95% CI, $114-$129] for continent patients). However, multilevel analyses showed that, after allowing for age and level of functional independence, the contribution of continence status to the cost of care depended on the functional independence of the patient (cognitive function for orthopaedic patients [P < 0.01] and motor function for stroke…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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