POSC393 The Clinical and Economic Burden Imposed By Ileostomy Creation: A Danish Registry Study

To determine the short- and long-term clinical and economic burden in people living with an ileostomy. Subjects with a creation of a permanent ileostomy between 2002-2014 were retrospectively identified in the Danish registries. A 1- and 2-years follow-up was defined as short- and long-term consequences on the clinical burden in terms of health care resource utilization (HRU) and the societal costs post stoma creation Cases were matched 1:4 to controls on age, gender, marital status, municipality, educational level and index year. A total of 4574 people living with an ileostomy was identified; mean age 60 years and male/female ratio of 46%/54%. In year 1, people living with an ileostomy compared to controls had, per person year, significantly more stoma related hospitalizations (2.7; 0.3 p=0.000), days in hospital (35.0; 1.5 p=0.000) and outpatient visits (23.6; 2.9 p<0.000). This corresponds to a 9-, 23- and 8-fold increase, respectively. Total direct health care cost, including somatic and psychiatric cost, for people living with an ileostomy compared to controls was €30,301 vs €3,507, and indirect costs, in terms of foregone earnings, was €3,486. The societal net cost per patient, including transfer payments, was estimated to €34,088 compared to the controls. In year 2, the corresponding figures were, stoma related hospitalizations (1.5; 0.3 p=0.000), days in hospital (9.3; 1.6 p=0.000) and outpatient visits (14.2; 3.1 p=0.000) which is a 5-, 6- and 5-fold increase, respectively. In the second year, the total direct health care cost was €15,867 vs €3,641, and indirect cost was €4,026. The societal net cost was €19,418. This case-controlled register study shows that people living with an ileostomy incur a surprisingly high clinical and economic burden to the Danish health care system compared to a matched population in terms of costs and HRU in both the first- and second-year post ileostomy creation.