The estimated economic burden of urinary incontinence-related complications in older adults Canada

BACKGROUNDS: Urinary incontinence (UI) is increasingly prevalent, particularly in older adults. UI management is frequently under-resourced and is associated with the development of potentially avoidable complications, placing a significant burden on the patient and on the healthcare system. This study aimed to estimate the cost of UI-related complications in Canada. METHODS: We conducted a comprehensive literature review using PubMed, Canadian Institute for Health Information (CIHI) data and citation mining to identify the prevalence of UI, UI-related complications, and associated treatment costs across each of acute care, long-term care (LTC), homecare and self/family care. UI-related complications quantified included: urinary tract infections (UTI), catheter-associated UTI, incontinence-associated dermatitis (IAD), UI-related pressure ulcers (PU), slips and falls, and fall-related injuries. The total economic burden to the Canadian healthcare system was estimated using UI prevalence, complication rates, and costs of treating complications in each setting. RESULTS: The estimated number of older Canadians with UI totaled 2,338,503 with an annual economic burden of UI-related complications up to $1,654,875,326. Acute care had the highest cost (up to $1,190,494,315), driven by skin-related complications (up to $525,692,182 for PU and $471,461,636 for IAD). Fall-related injuries, followed by UTIs, imposed the highest cost in LTC, homecare and self/family care, totaling up to $309,141,175 and $126,305,519, respectively. LTC had the lowest overall complication burden (up to $49,408,153), roughly one-third the cost in homecare, and one-fifth the cost in self/family care. CONCLUSIONS: UI and its associated complications represent a substantial economic burden to the Canadian healthcare system. This underscores the need for improved UI management strategies to contain associated costs.