Evolution and economic evaluation of fecal incontinence management in United States intensive care units: from historical containment to automated diversion

Fecal incontinence (FI) poses a significant clinical and economic challenge in the U.S. intensive care units (ICUs), affecting 9–40% of patients and contributing to billions of dollars in healthcare costs mainly towards complications such as incontinence-associated dermatitis (IAD), hospital-acquired pressure injuries (HAPI), and Clostridioides difficile infection (CDI). This review traces the evolution of FI management from rudimentary containment methods to the newest innovative Qoramatic Automated Stool Management (ASM) system with no balloon and zero radial pressure. We compared Qoramatic ASM to traditional absorbent pads and indwelling balloon catheters (IBCs) across four patients’ subgroups Results demonstrate that Qoramatic ASM reduces per-patient care costs by 80–94.5% ($242–$1,344 vs. $1,215–$24,615 for pads/IBCs), decreases nursing time 91–96% (6–14 vs. 66–348 min/day), and nearly eliminates leakage and device-related injuries. ASM also reduces HAPI and CDI incidence, shortening hospital stays by up to 30%. Qoramatic’s improved clinical outcomes, enhanced patient dignity, and reduced staff burden positioning it is a transformative solution for FI management in ICUs, warranting broader global adoption.