Clinical and Economic Burden of Peristomal Skin Complications in Patients With Recent Ostomies.
Charu Taneja, Debra Netsch, Bonnie Sue Rolstad and 3 others
PMID 28574928WHAT IT FOUND
Peristomal skin complications appeared in 36.7% of 128 ostomy patients within 90 days.
Those with complications had higher 120-day billed charges, longer index hospital stays, and more readmissions.
Key findings
01Forty-seven of 128 patients had evidence of peristomal skin complications within 90 days of ostomy surgery, including 28 with ileostomy, 18 with colostomy, and 1 with urostomy.
02Mean total healthcare costs over 120 days were $204,907 for patients with peristomal skin complications and $126,747 for patients without them, based on billed charges.
03Patients with peristomal skin complications had longer mean index admissions, 21.5 days versus 13.9 days, and were more likely to be readmitted, 47% versus 33%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small, and the authors did not perform statistical testing because power was low. Peristomal skin complications were identified from electronic record notes using keywords, not from a standardized clinical examination. Utilization and costs were all-cause, so the extra care cannot be separated from the ostomy surgery itself or other conditions. The financial figures are billed charges, not true costs. Patients with complications may differ from those without, so confounding could explain longer stays and higher charges. The urostomy group was very small, so its complication rate is unstable. Findings come from a single integrated health system and a single health plan, so generalizability is unknown.
The easy way to misread this
Do not read the $78,160 higher billed charges as proof that peristomal skin complications caused those costs. The study was observational, all-cause utilization and charges were counted, no statistical testing was done, and the authors state the finding shows association, not causation.