The clinical and economic burden of illness in the first two years after ostomy creation: a nationwide Danish cohort study

ABSTRACT

Background

Living with an ostomy is often associated with costly complications. This study examined the burden of illness the first two years after ostomy creation.

Methods

Data from Danish national registries included all adult Danes with an ostomy created between 2002 and 2014.

Results

Four cohorts consisted, respectively, of 11,385 subjects with a colostomy and 4,574 with an ileostomy, of which 1,663 subjects had inflammatory bowel disease (IBD) and 1,270 colorectal cancer as cause of their ileostomy. The healthcare cost was significantly higher for cases versus matched controls for all cohorts. In the first year, the total healthcare cost per person-year was €27,962 versus €4,200 for subjects with colostomy, €29,392 versus €3,308 for subjects with ileostomy, €15,947 versus €2,216 when IBD was the underlying cause, and €32,438 versus €4,196 when it was colorectal cancer. Healthcare costs decreased in the second year but remained significantly higher than controls. Hospitalization and outpatient services were primary cost drivers, with ostomy-related complications comprising 8–16% of hospitalization expenses.

Conclusion

Compared to controls, subjects with an ostomy bear a significant health and financial burden attributable to ostomy-related complications, in addition to the underlying disease, emphasizing the importance of better ostomy care to enhance well-being and reduce economic strain.

KEYWORDS:

• Burden of illness
• colorectal cancer
• colostomy
• healthcare cost
• ileostomy
• inflammatory bowel disease

Declaration of interest

F Bruun Andersen is an employee of Coloplast Danmark A/S, Denmark. J Kjellberg is employed by VIVE, the Danish Center for Social Science Research, Denmark, an independent research and analysis center. VIVE received funding from Coloplast for the contribution to this study. R Ibsen is an employee of i2Minds, an independent data analysis agency, which received funding from VIVE to this study. C Sternhufvud is an employee of Coloplast AB, Sweden. B Petersen is employed by MedDevHealth, Denmark, an independent consultancy, and received funding from Coloplast for the contribution to the study. The authors have no other relevant affiliation or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Author contributions

F Bruun Andersen was involved in conceptualization, methodology, project administration, review and editing. J Kjellberg contributed to methodology, validation, review and editing. R Ibsen provided data curation, formal analysis, investigation, methodology, review and editing. C Sternhufvud was involved in conceptualization, methodology, supervision, validation, review and editing. B Petersen contributed to methodology, review and editing.

Acknowledgments

Writing support was provided by Malene Bagger, MSc, PhD, employed by M Bagger Scientific Writing, which is an independent medical writing agency. The writing support was funded by Coloplast.

Posters

Results regarding subanalyses from the study have been previously presented as posters at conferences (Andersen FB, Kjellberg J, Ibsen R, Petersen B, Sternhufvud C. The short- and long-term clinical and economic burden of dehydration after ileostomy creation – a Danish register study. ISUCRS 2022. 27–29 October 2022. Istanhul, Turkey – Andersen FB, Kjellberg J, Ibsen R, Petersen B, Sternhufvud C. Burden of illness due to ileostomy depends on underlying diseases – a Danish register study. WOCNext® 2022. 5–8 June 2022. Fort Worth, TX, U.S.A. - Andersen FB, Kjellberg J, Ibsen R, Petersen B, Sternhufvud C. The clinical and economic burden imposed by ileostomy creation; a Danish registry study. ISPOR, October 2021. Copenhagen, Denmark).

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2024.2324047

Additional information

Funding

This study was funded by Coloplast.