Impact of Ostomy Self-Management Telehealth training for rural cancer survivors on health care utilization and economic outcomes in the United States.

PURPOSE: To assess the impact of a structured educational curriculum Ostomy Self-Management Telehealth (OSMT) treatment among cancer survivors residing in rural areas of the United States on selected measures of health care utilization, cost, and employment status. METHODS: This was a multi-site randomized controlled trial comparing OSMT treatment group against a control group receiving usual care (UC) in rural populations. OSMT treatment consisted of virtual group sessions led by trained peer ostomates delivered once a week over a 5-week period via video conferencing platforms. Surveys related to health care utilization were administered up to four times: baseline, post-session, 3-month and 6-month follow-up. RESULTS: Compared to the UC group, the OSMT group was associated with lower frequencies of in-person nurse (-57.2%; p = 0.015) and physician (-76.1%; p = 0.024) visits in the post-session follow-up survey; no significant differences were observed in the subsequent follow-up surveys. Moreover, the OSMT treatment group was also associated with lower ostomy-related emergency department visits (-88.3%; p = 0.119), lower direct out-of-pocket health care (-25.8%; p = 0.405) and travel costs (-47.7%; p = 0.105), as well as higher probability of full-time employment (18.9% vs. 12.3%; p = 0.179) and lower probability of claiming disability (14.3% vs. 18.9%; p = 0.459) in the 6-month follow-up; these differences, however, were not statistically significant. CONCLUSION: While not all statistically significant, the OSMT treatment was associated with some notable changes in the patterns of health care utilization and selected economic outcomes among ostomates residing in rural communities. This suggests that the OSMT treatment likely contributes to more efficient and cost-effective care in the target population. SYNOPSIS: Ostomy Self-Management Telehealth (OSMT) program seeks to reduce barriers to care and improve self-management skills especially among ostomates residing in rural communities. This study reports that OSMT was associated with lower in-person health care provider visits, suggesting OSMT may lead to more efficient and cost-effective care.