Ostomy Telehealth Self-management Training for Cancer Survivors

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Project Summary/Abstract Background: This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-21-055. Cancer-related care costs impact healthcare systems, patients, and families. Many of these costs may be modifiable. Our current funded study (Ostomy Telehealth Self-Management Training for Cancer Survivors (R01 CA204193, 4/1/19-3/31/24)) focuses on rural patients, who are a noted population of health care disparity. This proposal will build on our ongoing study. Aims: This proposed study will examine actual costs of care for patients who are eligible for the parent grant and identify what can be modified. Aim 1: Utilizing health system billing databases, assess and characterize the total direct cost of care associated with the ostomates who are eligible for the OSMT intervention by obtaining and analyzing their billing/claims data. Data will be acquired from three sites currently accruing for the parent grant: Geisinger Health System (GHS), Sanford Health (SH), and City of Hope National Medical Center (COH). Aim 2: Informed by Aim 1 billing data and using semi-structured interviews, identify ostomy-related modifiable factors that are expected to impact the total cost of care. Methods: Aim 1 will collect billing data from three sites (GHS, SH, COH). Aggregated data will be examined for total costs directly or indirectly related to ostomies. Aim 2 will be semi-structured patient interviews to gain an understanding of the perceived costs of living with an ostomy, with the direct goal of understanding which of these costs may lead to patient or system-related changes. Individual financial well-being will be a major focus of discussions. Findings from Aim 1 will inform the questions to be asked for Aim 2, and in turn, the findings from Aim 2 will generate a set of hypothesis that can be tested using the billing data obtained for Aim 1. Future Plans with Study Findings: The overriding goal will be to positively influence costs for patients, families, and healthcare systems. We anticipate impact to the ongoing parent study to continue to improve the intervention. There are likely to also be findings that lead to alternative interventions and study of modifiable cost issues for cancer survivors. Importantly, we plan to widely disseminate results to those who our findings would be most meaningful to make improvements in the long-term care of cancer survivors with ostomies.