A Cost and Value Analysis of Two Interventions with Incontinent Nursing Home Residents

Published In: Journal of the American Geriatrics Society, v. 43, Oct. 1995, p. 1112-1117

Posted on RAND.org on January 01, 1995

by John Schnelle, Emmett B. Keeler, Ron D. Hays, Sandra Simmons, Joseph G. Ouslander, Albert L. Siu

Analyzes the cost and value of implementing two interventions that have been shown to improve functional status in incontinent nursing home residents: (1) Prompted Voiding (PV), whereby people are reminded to go to the bathroom, and (2) Functional Incidental Training (FIT), whereby they are given mobility and exercise training. Both interventions have been shown to decrease the frequency of incontinence, and the second also improves mobility and endurance. Staff time allocations to implement both interventions were documented and the value of each intervention was assessed by asking patients to choose between the interventions (and their associated outcomes) and other nursing home services (such as moving to a private room). Labor costs for both interventions were approximately $5 per day higher than usual care. Patients preferred the outcomes of these interventions to more expensive alternative services, calculated to cost $10 per day. The authors conclude that both interventions have value for frail nursing home residents, and that protocols such as these should be considered seriously in the design of future programs targeting incontinent nursing home residents.

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