OBJECTIVES:

Hospitalized patients are often unable to void independently and frequently require UOM interventions that may include: indwelling catheters, intermittent catheterization, external catheters, absorbent underpads, bedpans or assistance with toileting. Until recently, external catheters were not an option for female patients. This analysis considers the potential clinical benefits, cost-effectiveness and budget impact of employing an FEC as part of a comprehensive UOM strategy.

METHODS:

This BIA evaluated two potential scenarios: 1) the substitution of an FEC for an indwelling urinary catheter, and 2) the substitution of an FEC for absorbent underpads. Using published clinical and economic data, the BIA determines the net economic impact across four separate outcomes: 1) catheter-associated urinary tract infections (CAUTIs), 2) incontinence-associated dermatitis (IAD), 3) patient falls associated with toilet-related activities, and 4) workflow efficiency (impact upon nursing time).

RESULTS:

In the scenario of discontinuing use of an indwelling urinary catheter, the economic benefit was found to be $5.78 per day gained from reducing the risk of CAUTI net of the incremental cost of the FEC. In the scenario of managing incontinence with absorbent underpads, the economic benefit was found to be $36.95 per day gained from reducing the risk of IAD, reducing the risk of patient falls associated with toilet-related activities, and reducing the nursing time associated with incontinence care, all net of the incremental cost of the FEC. The BIA projected 573 potentially avoidable indwelling catheter days and 1,941 potentially avoidable absorbent underpad days in a 10,000 admissions-per-year hospital yielding an annual cost savings of $75,030.

CONCLUSIONS:

External catheters – a UOM option that have long existed for male patients – should be considered, when appropriate, for female patients. This BIA suggests the potential for a significant economic savings and clinical benefits when FECs are substituted, in appropriate circumstances, for indwelling urinary catheters and absorbent underpads.