Stoma care nurses: good value for money?

Decreasing financial resources in health services often lead to wholesale budget reducing in hospitals. Enterostomal therapists are more and more concerned by this situation. Data on the cost-effectiveness of stoma therapy have not existed, a gap filled by the present study. From January to December 1996 data from 94 patients about therapy-related costs, outcome, and evaluation of stoma therapy from the patient's point of view were ascertained prospectively. For an average (SD) of 14.6 (7.1) patient contacts for stoma planning, advice, care, and so on the average duration was 12.9 (9.1) minutes per contact. At an average exchange rate of 1.50 German marks (DM) per US dollar in 1996 the enterostomal therapist's part of the total staff costs was US$15,212 (2.7%), the cost of stoma products was US$7750 (4.5% of the total costs of medical supplies). About 89.3% of the patients classified the enterostomal therapist necessary and indispensable; 70.3% of the patients said they could cope with their stoma very well to well at the time of questioning. In contrast, 69.2% of those questioned declared that without the care by the enterostomal therapist in hospital they would be able to cope with their stoma only poorly to very poorly. We conclude that from the patient's point of view the costs of our stoma therapy are justifiably low. Therefore we see no reason for a discussion about rationalization measures regarding our stoma therapy staff.