BACKGROUND/AIMS: The optimal timing for the closure of loop ileostomies remains controversial. The aim of the current study was to investigate whether early ileostomy closure (EC) (<2 weeks post-formation) results in significant healthcare savings as against late closure (LC). METHODS: Patients with available cost data that underwent EC between January 2008 and December 2012 were compared against matched patients undergoing LC during the same period. Direct hospital costs for the two groups were compared. RESULTS: There were 42 EC patients and 61 LC patients. EC patients had significantly less ileostomy-related complications (p < 0.001) and hospital readmissions (p < 0.001). Operative time (p < 0.001) and operative cost (p = 0.002) were also both significantly less in the EC group. Community nursing costs favoured the LC group (p = 0.047). The EC group had an increased post-closure wound infection rate (p = 0.02). The mean total direct cost per patient was NZD 13,724 (SD NZD 3,736) for EC and NZD 16,728 (SD NZD 8,028) for LC. Representing an average costs saving of NZD 3,004 per patient favouring EC (p = 0.012). CONCLUSION: Although EC increases the post-closure wound infection rate, EC reduces ileostomy complications, hospital readmissions and operative costs resulting in significant healthcare savings. In order to improve patient outcomes and make EC even more cost effective, efforts should be taken to reduce wound infections.
BACKGROUND/AIMS: The optimal timing for the closure of loop ileostomies remains controversial. The aim of the current study was to investigate whether early ileostomy closure (EC) (<2 weeks post-formation) results in significant healthcare savings as against late closure (LC). METHODS:Patients with available cost data that underwent EC between January 2008 and December 2012 were compared against matched patients undergoing LC during the same period. Direct hospital costs for the two groups were compared. RESULTS: There were 42 ECpatients and 61 LCpatients. ECpatients had significantly less ileostomy-related complications (p < 0.001) and hospital readmissions (p < 0.001). Operative time (p < 0.001) and operative cost (p = 0.002) were also both significantly less in the EC group. Community nursing costs favoured the LC group (p = 0.047). The EC group had an increased post-closure wound infection rate (p = 0.02). The mean total direct cost per patient was NZD 13,724 (SD NZD 3,736) for EC and NZD 16,728 (SD NZD 8,028) for LC. Representing an average costs saving of NZD 3,004 per patient favouring EC (p = 0.012). CONCLUSION: Although EC increases the post-closure wound infection rate, EC reduces ileostomy complications, hospital readmissions and operative costs resulting in significant healthcare savings. In order to improve patient outcomes and make EC even more cost effective, efforts should be taken to reduce wound infections.
Authors: Fateme Rajabiyazdi; Marylise Boutros; Natasha G Caminsky; Jeongyoon Moon; Nancy Morin; Karim Alavi; Rebecca C Auer; Liliana G Bordeianou; Sami A Chadi; Sébastien Drolet; Amandeep Ghuman; Alexander Sender Liberman; Tony MacLean; Ian M Paquette; Jason Park; Sunil Patel; Scott R Steele; Patricia Sylla; Steven D Wexner; Carol-Ann Vasilevsky Journal: Surg Endosc Date: 2022-10-04 Impact factor: 3.453
Authors: Jennifer Park; Eva Angenete; David Bock; Adiela Correa-Marinez; Anne K Danielsen; Jacob Gehrman; Eva Haglind; Jens E Jansen; Stefan Skullman; Anette Wedin; Jacob Rosenberg Journal: Surg Endosc Date: 2019-03-25 Impact factor: 4.584
Authors: Greg A Turner; Kari A Clifford; Rossi Holloway; John C Woodfield; Mark Thompson-Fawcett Journal: Colorectal Dis Date: 2022-02-28 Impact factor: 3.917