Background Inappropriate feeding is a risk factor in many pathological conditions and causes direct and indirect costs. A number of inpatients are malnourished, resulting in complications and hospital stay prolongation. Objectives To compare, with HTA methodology, food distribution systems, i.e. "trolley service" versus "plate". Materials and methods A review of the literature, analysis of organizational efficiency, a customer satisfaction survey and comparisons between systems were carried out. Results The "plate service" system requires less resources and a spare of time in delivering food to the patients but there remain some organizational activities and caring to patients who need help feeding. The "trolley" system is more economic (cost of a meal €6,650 versus €6,910). In the ethical-social analysis it has been shown a higher workingtime availability with the "plate" system, that could be used to assist patients with their meals. Caregiving support must
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