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Article

Value-Based Healthcare in Ostomies

1
Hospital Regional Universitario de Málaga, 29010-Málaga, Spain
2
Faculty of Economics, University of Málaga, 29001-Málaga, Spain
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Hospital Universitario “Virgen de la Victoria”, 29010-Málaga, Spain
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Hospital de St Ana. Motril, 18600-Granada, Spain
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Hospital Universitario de Puerto Real, 11510-Cádiz, Spain
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Hospital Universitario “Nuestra Señora de Valme”, 41014-Sevilla, Spain
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Hospital Universitario Puerta del Mar, 11009-Cádiz, Spain
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Hospital de Poniente, El Ejido, 04700-Almería, Spain
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Hospital “Juan Ramón Jiménez”, 21006 Huelva, Spain
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Complejo Hospitalario de Jaén, 23007-Jaén, Spain
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Hospital de Pozoblanco, 14400-Córdoba, Spain
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Hospital Universitario Virgen de la Nieves. 18014-Granada, Spain
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Hospital San Agustin (Linares). 23700-Jaén, Spain
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Hospital Costa del Sol, Marbella, 29603-Málaga, Spain
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Hospital San Juan de la Cruz (Übeda), 23400-Jaén, Spain
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Hospital General de Riotinto, 21660-Huelva, Spain
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Department of Pharmacology, School of Medicine, University of Málaga, 29010-Málaga, Spain
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School of Medicine, University of Málaga, 29010-Málaga, Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(16), 5879; https://doi.org/10.3390/ijerph17165879
Received: 15 July 2020 / Revised: 6 August 2020 / Accepted: 10 August 2020 / Published: 13 August 2020
(This article belongs to the Special Issue Statistical Advances in Epidemiology and Public Health)
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. View Full-Text
Keywords: ostomy; organizational innovation; nurse specialists; quality-adjusted life years; health care costs; cost-benefit analysis; health resources; prospective studies ostomy; organizational innovation; nurse specialists; quality-adjusted life years; health care costs; cost-benefit analysis; health resources; prospective studies
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MDPI and ACS Style

Montesinos Gálvez, A.C.; Jódar Sánchez, F.; Alcántara Moreno, C.; Pérez Fernández, A.J.; Benítez García, R.; Coca López, M.; Bienvenido Ramírez, M.P.; Cabrera López, M.; Vázquez Burrero, L.; Jurado Berja, P.; Sánchez García, R.; Cebrián, J.M.; Hervas García, M.L.; López Fernández, R.; Pérez Jiménez, C.; Reyes Vico, M.A.; Vargas Villegas, A.B.; García-Agua Soler, N.; García Ruiz, A.J. Value-Based Healthcare in Ostomies. Int. J. Environ. Res. Public Health 2020, 17, 5879. https://doi.org/10.3390/ijerph17165879

AMA Style

Montesinos Gálvez AC, Jódar Sánchez F, Alcántara Moreno C, Pérez Fernández AJ, Benítez García R, Coca López M, Bienvenido Ramírez MP, Cabrera López M, Vázquez Burrero L, Jurado Berja P, Sánchez García R, Cebrián JM, Hervas García ML, López Fernández R, Pérez Jiménez C, Reyes Vico MA, Vargas Villegas AB, García-Agua Soler N, García Ruiz AJ. Value-Based Healthcare in Ostomies. International Journal of Environmental Research and Public Health. 2020; 17(16):5879. https://doi.org/10.3390/ijerph17165879

Chicago/Turabian Style

Montesinos Gálvez, Ana C., 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. 2020. "Value-Based Healthcare in Ostomies" International Journal of Environmental Research and Public Health 17, no. 16: 5879. https://doi.org/10.3390/ijerph17165879

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