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

BackgroundLiving with an ostomy is often associated with costly complications. This study examined the burden of illness the first two years after ostomy creation.MethodsData from Danish national registries included all adult Danes with an ostomy created between 2002 and 2014.ResultsFour 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 euro27,962 versus euro4,200 for subjects with colostomy, euro29,392 versus euro3,308 for subjects with ileostomy, euro15,947 versus euro2,216 when IBD was the underlying cause, and euro32,438 versus euro4,196 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.ConclusionCompared 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.