OBJECTIVES: Having an ostomy is usually a chronic condition implying a clinical and economic burden for patients and society. The aim of the study was, based on a German claims dataset, to examine the consequences of illness associated with having an ostomy, and to quantify the resource utilisation.

METHODS: German ostomates were identified using real-world claims data from year 2007-2015 of 2.5m beneficiaries and based on a dataset from a subset of statutory health insurance companies. The outcome analysis was for the year 2015 and only included ostomates with a permanent stoma and stoma product claims in all four quarters of 2015. The control group consisted of a random sample of beneficiaries, matched 1:50 on age and gender.

RESULTS: A total of 1589 ostomates were identified from the claims database. They had a mean age of 71.9 (SD=14.2) and 48.7% were female; 1079 (67.9%) colostomists, 216 (13.6%) ileostomists and 294 (18.5%) urostomists. A high annual prevalence of depression (20.8%), sleep disorders (11.4%), volume depletion (7.9%) and acute renal failure (4.2%; 8.5% for urostomists) was detected. Ileostomists exhibited an underreported prevalence of skin complications diagnosed in outpatient care (13.9%) compared to the prevalence of skin complications described in the literature. The annual cost of an ostomate was 15,754€ (SD=21,666€) compared to 5,380€ (SD=11,574€) for the control group, p<0.001. Of the total cost, inpatient costs accounted for 36,0%, outpatient for 9,4%, pharmaceuticals for 23,0% and stoma nursing and products for 18,1%.

CONCLUSIONS: The analysis showed that ostomates impose a significantly higher economic burden on the German health care system compared to a matched population in terms of prevalence of comorbidities and costs. Further investigations are warranted to provide additional insights and clarification of the economic burdens linked to persons with an ostomy.