Labor costs associated with incontinence in long-term care facilities

Objectives. To understand the labor resource consumption in caring activities of long-term care residents with versus without urinary incontinence (UI) and the variation in consumption patterns across shifts and facility types. Methods. This prospective study was conducted in three phases. Phase I of the study developed a taxonomy of the caring activities involved in the care of the incontinent patient and of the control group patient. In Phase 11, the frequency of these activities was assessed. Phase III extrapolated the cost impacts of incontinence. The sample consisted of 37 long-term care facilities in the vicinity of Winston-Salem, North Carolina, along with a supplemental sample of 12 facilities in the vicinity of Chapel Hill, North Carolina. The study examined the costs of labor, supplies, and services. To our knowledge, this is the first study to apply microcosting approaches to UI. Results. All things being equal, the incremental labor costs (per shift) were $3.31 (in 2002 dollars) for patients with occasional UI and $5.16 for patients with frequent UI. Combining patients with frequent UI (more than 70% of all UI patients) and occasional UI, the weighted average incremental costs per shift were $4.52. Conclusions. With incremental labor costs of $4.52 per patient per shift, UI costs an additional $13.57 to treat per day, or $4957 annually. Our findings can be used to capture the "averted costs" in long-term care facilities from curing UI.