The Burden of Fecal Incontinence: Evaluating the Societal Impact in Terms of Economic Burden and Health-Related Quality of Life

Introduction: Fecal incontinence (FI) is a chronic condition characterized by the involuntary loss of stool, significantly impacting health-related quality of life (HRQoL) and imposing a substantial economic burden on society. Methods: This bottom-up, retrospective, cross-sectional burden of disease study offers a comprehensive cost analysis of FI in a Dutch population sample. Utilizing the iMTA Medical Consumption Questionnaire (MCQ) and the iMTA Productivity Cost Questionnaire (PCQ), we analyzed costs over a 3-month period from a societal perspective, which encompasses healthcare costs, out-of-pocket expenses, and productivity losses. Non-parametric bootstrapping was applied to identify differences in costs between several subgroups of patients. Additionally, we assessed HRQoL using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. Differences in HRQoL between subgroups were determined using the nonparametric Mann-Whitney U test. Results: Cost and HRQoL data were collected from 80 FI patients aged 39-89 (82.5% female). The mean societal costs were <euro>2424 per patient per quarter, of which <euro>1572 can be contributed to healthcare costs. Notably, unemployed patients incurred significantly higher costs compared to employed and retired patients. No significant difference in costs was seen between subgroups based on gender, age, educational level, or frequency of FI episodes. The mean HRQoL score was 0.72 (SD 0.78). Younger and unemployed patients reported lower HRQoL scores. Conclusion: This study demonstrates that FI negatively impacts HRQoL and has a considerable impact on societal costs, extending beyond direct healthcare expenses. Policymakers, healthcare providers, and employers should take these findings into account when designing management strategies and allocating resources for FI treatment and support.