INTRODUCTION:  Irritation of the peristomal skin is a significant concern for ostomates, and factors affecting its occurrence are of interest to WOC nurses.  This study identifies relationships between financial responsibility for appliances and change habits, and between change habits and peristomal skin condition.

METHODOLOGY:  The retrospective study uses a subset (n = 1303) of the data from the Ostomy Comprehensive Health and Life Assessment survey (N = 1507).  This ongoing survey has been distributed in the United States and Canada by electronic and conventional mail, as well as through ostomy retailers and associations.  In its current revision, the survey contains more than 120 questions soliciting both open- and closed-end responses.

RESULTS:  Participants paying the entire cost of their ostomy appliances were more likely than those receiving at least partial payment by insurance to report changing appliances only when they begin to fail (Chi-square, p < .0001).  In addition, compared to participants who reported changing appliances before they are expected to fail or on a regular basis they are comfortable with, those who reported changing appliances only when they begin to fail also reported higher levels of peristomal skin irritation on a five-point ordinal scale (Wilcoxon rank-sum, Bonferroni, p < .01).

DISCUSSION:  The data suggest that changing an ostomy appliance before it begins to fail may help to prevent peristomal skin irritation and that those who receive financial assistance for their appliances may be more likely to follow such a regimen.  While the data do not support a direct causal relationship between financial responsibility and skin irritation, they may provide the justification for a prospective study of relationships between reimbursement policies, patient financial concerns and patient outcomes.

DISCLOSURE:  Research funding from Hollister Incorporated is gratefully acknowledged.