title: A Cost-Utility Model of Care for Peristomal Skin Complications.
abstract: OBJECTIVE
  The aim of this study was to evaluate the economic and humanistic implications of using ostomy components to prevent subsequent peristomal skin complications (PSCs) in individuals who experience an initial, leakage-related PSC event.
  
  
  METHODS
  Cost-utility analysis.
  
  
  METHODS
  We developed a simple decision model to consider, from a payer's perspective, PSCs managed with and without the use of ostomy components over 1 year. The model evaluated the extent to which outcomes associated with the use of ostomy components (PSC events avoided; quality-adjusted life days gained) offset the costs associated with their use.
  
  
  RESULTS
  Our base case analysis of 1000 hypothetical individuals over 1 year assumes that using ostomy components following a first PSC reduces recurrent events versus PSC management without components. In this analysis, component acquisition costs were largely offset by lower resource use for ostomy supplies (barriers; pouches) and lower clinical utilization to manage PSCs. The overall annual average resource use for individuals using components was about 6.3% ($139) higher versus individuals not using components. Each PSC event avoided yielded, on average, 8 additional quality-adjusted life days over 1 year.
  
  
  CONCLUSIONS
  In our analysis, (1) acquisition costs for ostomy components were offset in whole or in part by the use of fewer ostomy supplies to manage PSCs and (2) use of ostomy components to prevent PSCs produced better outcomes (fewer repeat PSC events; more health-related quality-adjusted life days) over 1 year compared to not using components.
authors.affiliation: Nancy Neil, PhD, Chordata Consulting, LLC, Tacoma, Washington.Gary Inglese, RN, Hollister Incorporated, Libertyville, Illinois.Andrea Manson, BSN, RN, ET, Ostomy Care and Supply Centre, New Westminster, British Columbia, Canada.Arden Townshend, BSN, RN, ET, Ostomy Care and Supply Centre, New Westminster, British Columbia, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Neil
authors.forename: Gary
authors.initials: G
authors.lastname: Inglese
authors.forename: Andrea
authors.initials: A
authors.lastname: Manson
authors.forename: Arden
authors.initials: A
authors.lastname: Townshend
mesh_terms: D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D006801:Humans; D010030:Ostomy / Q000009:adverse effects* / Q000191:economics / Q000451:nursing; D012648:Self Care; D017592:Skin Care; D012871:Skin Diseases / Q000191:economics* / Q000209:etiology* / Q000451:nursing; D054047:Surgical Stomas / Q000009:adverse effects*