Overall quality of life and difficulty paying for ostomy supplies in the Veterans Affairs ostomy health-related quality of life study: an exploratory analysis.
OBJECTIVE
To explore whether there was a significant relationship between difficulty paying for ostomy supplies and overall quality of life among a sample of ostomates receiving care from the Veterans Health Administration (VHA).


METHODS
The data were collected as part of the Veterans Affairs (VA) Ostomy Health-Related Quality of Life Study, in which 511 respondents (239 cases, 272 controls) completed a survey instrument that included the modified City of Hope Quality of Life (mCOH-QOL) Ostomy questionnaire, SF-36V, and sociodemographic items. Responses from the 239 cases (ie, patients with intestinal stomas) were used in this analysis. The modified City of Hope Quality of Life Ostomy questionnaire item, "How good is your overall quality of life?," was the dependent variable for this analysis. The primary independent variable was the response (yes/no) to the item, "If you pay for any of the (ostomy) costs, is it difficult for you?" A hierarchical regression model was used to examine whether difficulty paying was significantly related to overall quality of life after adjusting for age, income, race/ethnicity, and physical health.


RESULTS
After accounting for the proportion of variance explained by age, income, race/ethnicity, and physical health, the additional proportion of variance explained by difficulty paying was statistically significant. Individuals reporting difficulty paying had a roughly 1 point lower (ie, beta-coefficient = -1.052; SE = 0.481) overall quality of life score on the 11-point scale.


CONCLUSIONS
We found a significant association between difficulty paying for ostomy supplies and overall quality of life. Although the cross-sectional study design does not allow causal inference, the results suggest a relationship that merits further examination.
Coons
Stephen Joel
SJ
Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA. coons@pharmacy.arizona.edu
Chongpison
Yuda
Y
Wendel
Christopher S
CS
Grant
Marcia
M
Krouse
Robert S
RS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy / Q000191:economics* / Q000523:psychology; D003430:Cross-Sectional Studies; D004209:Disposable Equipment / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005767:Gastrointestinal Diseases / Q000191:economics* / Q000601:surgery; D006801:Humans; D007081:Ileostomy / Q000191:economics* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011594:Psychometrics; D011788:Quality of Life; D012107:Research Design; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*