OBJECTIVES: To explore the health care resource utilization and associated costs among persons with either a temporary or permanent stoma in Sweden.

METHODS: Subjects with a creation of a stoma between 2006-2019 were retrospectively identified with ICD-10 codes in Swedish national registries and matched 1:2 with controls. Subgroups for permanent and temporary colostomy and ileostomy were created based on procedural codes for stoma reversal. Health resource utilization (HRU) and costs were estimated for the first patient year after stoma creation.

RESULTS: 19,645 persons had a colostomy and 16,408 an ileostomy, hereof 2,772 (14%) and 8,144 (50%) having a temporary stoma, respectively. Average time to reversal was 11.5 vs 9.4 months for colostomy and ileostomy.

Mean age of the colostomy subgroups was 72.3 (permanent) and 61.3 (temporary) years. The two subgroups were hospitalized 3.1 vs 1.6 times, spent 27.3 vs 9.7 days in hospital, had 6.4 vs 8.8 specialized outpatient visits and 2.0 vs 1.6 emergency visits per patient year. The direct healthcare costs were estimated to €35,351 vs €24,461 year 1.

Mean age of the ileostomy subgroups was 65.1 (permanent) and 61.6 (temporary) years. The two subgroups were hospitalized 4.0 vs 2.1 times, spent 35.2 vs 12.5 days in hospital, had 9.3 vs 9.2 specialized outpatient visits and 2.5 vs 1.6 emergency visits per patient year. The direct healthcare costs were estimated to €40,057 vs €25,959 year 1.

HRU outcomes and costs were statistically significantly different from control group across all sub-cohorts.

CONCLUSIONS: Outcomes and costs indicate a high burden of illness for persons with a stoma compared to the control groups. Persons with permanent stoma had a higher hospitalization rate and longer hospital stays compared to persons with temporary stoma the first year after surgery, while the frequency of outpatient visits was similar between groups.