Post-surgical acute care utilization and cost of care among cancer survivors with an ostomy: Findings from three large hospital systems in the United States

Abstract

Purpose

To describe patterns of 6-month total cost of care and acute care utilization among cancer survivors who received ostomy surgeries in 3 large hospital systems in the United States between 2018 and 2022 and to identify reasons for acute care utilization.

Methods

A retrospective cohort study using electronic medical records and the corresponding hospital revenue data obtained from 3 geographically diverse hospital systems in the United States was performed. 6-month all-cause post-surgical encounters subsequent to respective ostomy surgery dates were included. Clinical reasons for acute care utilization were captured and examined via available diagnosis codes.

Results

Mean six-month total cost of care per patient varied greatly by hospital and by payer type, ranging between $18,000 and $80,000. Inpatient care was the largest driver of these cost, accounting for 70 % of the total cost of care. In the sample, 56 % of the patients experienced one or more post-surgical inpatient admissions over a six-month period. Moreover, 26 % of the acute care events were associated with primary or secondary diagnosis codes potentially attributable to post-surgical ostomy-related complications, accounting for approximately 18 % of the total cost. Patients who received urostomy and/or had metastatic cancer had higher rates of acute care utilization, although statistical significances were not achieved.

Conclusion

The results are indicative of significant financial burdens as well as morbidities associated with post-surgical ostomy care that are common across hospital systems. Some of these cost burdens are potentially avoidable with improved ostomy follow-up care.