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The Economic Impact of Incontinence in Australia Download The The economic impact of incontinence in Australia Continence Foundation of Australia 2011 The economic impact of incontinence in Australia Contents Glossary ..................................................................................................................................... i Acknowledgements.................................................................................................................. iii Executive Summary .................................................................................................................. iv 1 Background and methods ............................................................................................... 1 1.1 Literature searches ........................................................................................................... 1 2 Epidemiology of incontinence in Australia ....................................................................... 2 2.1 Definition and pathogenesis of incontinence ..................................................................... 2 2.2 Risk factors and comorbidity ............................................................................................. 2 2.3 Mortality........................................................................................................................... 3 2.4 Prevalence ........................................................................................................................ 3 2.5 Prevalence projections to 2030 ......................................................................................... 9 3 Health costs .................................................................................................................. 13 3.1 Description ..................................................................................................................... 13 3.2 Methodology .................................................................................................................. 13 3.3 Health expenditure in 2010 ............................................................................................. 13 3.4 Projections to 2020 ......................................................................................................... 23 4 Other financial costs ..................................................................................................... 26 4.1 Productivity losses .......................................................................................................... 26 4.2 Informal care costs .......................................................................................................... 28 4.3 Community care costs ..................................................................................................... 29 4.4 Residential aged care ...................................................................................................... 31 4.5 Continence management products, including laundry costs ............................................. 32 4.6 Government assistance for continence management products ........................................ 34 4.7 Welfare payments........................................................................................................... 42 4.8 Deadweight losses from transfers ................................................................................... 43 4.9 Summary of other financial costs .................................................................................... 44 5 Burden of disease ......................................................................................................... 45 5.1 Methodology .................................................................................................................. 45 5.2 Burden of disease due to incontinence ............................................................................ 46 6 The total cost of incontinence in Australia ..................................................................... 48 6.1 Cost summary ................................................................................................................. 48 References .............................................................................................................................. 51 Appendix A : Literature searches ............................................................................................. 58 Appendix B : Prevalence of incontinence by severity of disease............................................... 59 Limitation of our work ............................................................................................................... 61 Deloitte Access Economics i The economic impact of incontinence in Australia Charts Chart 2.1 : Community dwelling population with incontinence, 2010 to 2030 ......................... 10 Chart 2.2 : RAC residents with incontinence, 2010 to 2030...................................................... 11 Chart 3.1 : Health system expenditure by payer, 2010 ($270.8 million) (a) .............................. 22 Chart 3.2 : Health system costs by modality, 2010 ................................................................... 23 Chart 3.3 : Incontinence health system costs, 2010 and 2020 .................................................. 25 Chart 6.1 : Components of total economic cost of incontinence in 2010 (total $66.7 billion) ... 49 Chart 6.2 : Total cost of incontinence by bearer, 2010 ............................................................. 50 Tables Table 2.1 : Potential data sources for incontinence prevalence estimates ................................. 4 Table 2.1 (Continued): Potential data sources for incontinence prevalence estimates ............... 6 Table 2.2 : Prevalence of urinary (assessed by ISI) and faecal incontinence (assessed by Wexner, excluding flatus ) in households, 2004 ......................................................................... 7 Table 2.3 : Aged Care Funding Instrument appraisal responses, June 2009 ................................ 9 Table 2.4 : Prevalence of urinary and faecal incontinence in 2010 and 2030, community and RAC populations ..................................................................................................................... 12 Table 3.1 : GP visits for incontinence (2010) ............................................................................ 14 Table 3.2 : Type of urinary and or bowel incontinence related GP visits and associated cost (2010) ..................................................................................................................................... 15 Table 3.3 : Number of GP referrals to medical specialists for incontinence per annum ............ 15 Table 3.4 : Medications prescribed by GPs for patients with incontinence (2010) .................... 17 Table 3.5 : GP referrals to allied health for urinary and bowel incontinence (2010) ................. 18 Table 3.6 : Pathology referrals by GPs for patients with urinary and/or bowel incontinence (2010) ..................................................................................................................................... 19 Table 3.7 : Medical imaging referrals by GPs for patients with urinary and/or bowel incontinence (2010) ................................................................................................................ 20 Table 3.8 : NCMS funding ........................................................................................................ 21 Table 3.9 : Health system expenditure by payer, 2010 ($ million) ............................................ 22 Table 3.10 : Health system costs - projections to 2020 ............................................................ 24 Table 4.1 : Employment rate of people with a disability who experience incontinence and difference with general, disabled population, 2003 ................................................................. 27 Table 4.2 : AWE for full-time and part-time employed in 2010 ................................................ 27 Table 4.3 : Productivity loss due to lower employment, 2010 .................................................. 27 Deloitte Access Economics ii The economic impact of incontinence in Australia Table 4.4 : Distribution of productivity losses, 2010 ($40.6 billion (a)) ..................................... 28 Table 4.5 : Proportion of package recipients needing help with incontinence and associated cost 30 Table 4.6 : Direct costs of continence care, selected nursing homes and hostels, 2001 and 201032 Table 4.7 : Median direct cost of urinary incontinence in women per week, Au$(a) .................. 33 Table 4.8 : Average cost per week for incontinence products (AU$) ........................................ 34 Table 4.9 : Summary of State and Territory support programs also providing continence management assistance .......................................................................................................... 37 Table 4.10 : Government assistance for continence management products 2010 .................... 42 Table 4.11 : Summary of other financial costs associated with incontinence in 2010 .............. 44 Table 5.1 : DALYs lost due to incontinence by disease severity in the community, 2010 .......... 47 Table 5.2 : Disability weights for urinary and faecal incontinence in the RAC population and DALYs lost by disease severity, 2010 ....................................................................................... 47 Table 6.1 : Summary of total cost of
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