Value-Based Healthcare in Ostomies

Ana C. Montesinos Gálvez, Francisco Jódar Sánchez, Carmen Alcántara Moreno, Antonio J. Pérez Fernández, Rosario Benítez García, Mercedes Coca López, María Paz Bienvenido Ramírez, Monserrat Cabrera López, Luisa Vázquez Burrero, Pilar Jurado Berja, Raquel Sánchez García, Josefa Martín Cebrián, María Luz Hervas García, Remedios López Fernández, Claudia Pérez Jiménez, María Antonia Reyes Vico, Ana Belén Vargas Villegas, Nuria García-Agua Soler and Antonio J. García Ruiz
Additional contact information
Ana C. Montesinos Gálvez: Hospital Regional Universitario de Málaga, 29010-Málaga, Spain
Francisco Jódar Sánchez: Faculty of Economics, University of Málaga, 29001-Málaga, Spain
Carmen Alcántara Moreno: Hospital Universitario “Virgen de la Victoria”, 29010-Málaga, Spain
Antonio J. Pérez Fernández: Hospital de St Ana. Motril, 18600-Granada, Spain
Rosario Benítez García: Hospital Universitario de Puerto Real, 11510-Cádiz, Spain
Mercedes Coca López: Hospital Universitario “Nuestra Señora de Valme”, 41014-Sevilla, Spain
María Paz Bienvenido Ramírez: Hospital Universitario Puerta del Mar, 11009-Cádiz, Spain
Monserrat Cabrera López: Hospital de Poniente, El Ejido, 04700-Almería, Spain
Luisa Vázquez Burrero: Hospital “Juan Ramón Jiménez”, 21006 Huelva, Spain
Pilar Jurado Berja: Complejo Hospitalario de Jaén, 23007-Jaén, Spain
Raquel Sánchez García: Hospital de Pozoblanco, 14400-Córdoba, Spain
Josefa Martín Cebrián: Hospital Universitario Virgen de la Nieves. 18014-Granada, Spain
María Luz Hervas García: Hospital San Agustin (Linares). 23700-Jaén, Spain
Remedios López Fernández: Hospital Universitario de Puerto Real, 11510-Cádiz, Spain
Claudia Pérez Jiménez: Hospital Costa del Sol, Marbella, 29603-Málaga, Spain
María Antonia Reyes Vico: Hospital San Juan de la Cruz (Übeda), 23400-Jaén, Spain
Ana Belén Vargas Villegas: Hospital General de Riotinto, 21660-Huelva, Spain
Nuria García-Agua Soler: Department of Pharmacology, School of Medicine, University of Málaga, 29010-Málaga, Spain
Antonio J. García Ruiz: School of Medicine, University of Málaga, 29010-Málaga, Spain

IJERPH, 2020, vol. 17, issue 16, 1-15

Abstract: In order to achieve significant improvements in quality, cost, and accessibility (the health “iron triangle”), innovation in organizational and service delivery models is necessary to increase the value of healthcare. The aim of this study is to evaluate the efficiency of a model of organizational innovation based on advanced practice nurse in the care of people with ostomies (APN-O) versus usual care. An observational, exploratory, analytical, prospective study with a six-month follow-up was carried out at 12 hospitals that implemented this model in Andalusia. A total of 75 patients who had undergone a digestive elimination ostomy and/or a urinary ostomy were followed for six months. Clinical outcomes, healthcare resources, health-related quality of life, and willingness to pay (WTP) were analyzed. The economic evaluation was conducted from a societal perspective, including healthcare costs and indirect costs. The cost difference between the two models was €136.99 and the quality-adjusted life year (QALY) gained was 0.05965 (€2297 per QALY gained). At six months, the mean of WTP was €69 per APN-O consultation. This model contributes to increasing the value-based healthcare in ostomies. Results of this study suggested that APN-O is an effective patient management model for improving their health status and is highly efficient.

Keywords: ostomy; organizational innovation; nurse specialists; quality-adjusted life years; health care costs; cost-benefit analysis; health resources; prospective studies (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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