Economic analysis of costs with enteral and parenteral nutritional therapy according to disease and outcome

Abstract

Objective To conduct an economic analysis of enteral and parenteral diet costs according to the type of disease and outcome (survivors versus deaths).Methods It is a cross-sectional, observational, retrospective study with a qualitative and quantitative design, based on analysis of hospital accounts from a healthcare insurance provider in the Southern region of Brazil.Results We analyzed 301 hospital accounts of individuals who used enteral and parenteral diets. The total cost of the diet was 35.4% of hospital account total costs. The enteral modality accounted for 59.8% of total dietary costs. The major costs with diets were observed in hospitalizations related to infections, cancers and cerebro-cardiovascular diseases. The major costs with parenteral diet were with admissions related by cancers (64.52%) and dementia syndromes (46.17%). The highest ratio between total diet costs with the total of hospital account costs was in dementia syndromes (46.32%) and in cancers (41.2%). The individuals who died spent 51.26% of total of hospital account costs, being 32.81% in diet (47.45% of total diet value and 58.81% in parenteral modality).Conclusion Enteral and parenteral nutritional therapies account for a significant part of the costs with hospitalized individuals, especially in cases of cancers and dementia syndromes. The costs of parenteral diets were higher in the group of patients who died.

Relationship between Expenses on Nutritional Therapy and Mortality Rate in Public Hospitals in Salvador, Bahia: An Ecological Study

“…7 The present work was also able to verify that in public hospitals It is important to point out that not only the nutritional condition of the patient determines the mortality rate, but also the length of hospitalization and other factors such as the clinical profile, the procedures offered in the hospital environment, the availability of specialties and the complexity of the site. 7 In the present study, it was not possible to stratify, isolate or correlate other factors influencing the mortality rate in the hospitals studied, which is a bias. The main limitation of the present study was the impossibility of analyzing other information about the individuals who used NT, since in the DATASUS there is only data on the amount of money spent on this procedure.…”

“…These consequences have proportional repercussions on increased medical and hospital costs, representing an increment of 19% to 29%. 7 In this scenario, the presence of the clinical nutrition physician and a multidisciplinary team is indispensable, especially for the malnourished patient. These professionals could easily identify individuals at nutritional risk and treat them according to their needs.…”

“…There are also scarce data that contribute for public funding managers to choose to implement an MNTT in their hospitals. 7 Thus, the present study aims to analyze the relationship between the expenses on NT and the mortality outcome in public hospitals in the city of Salvador, Bahia, Brazil.…”

Análise de custos de nutrição parenteral

“…It is possible, with the cost analysis, to allocate and propose alternatives for the best execution of activities. 11 In a study carried out in Curitiba, 12 nutritional therapies, enteral and parenteral, accounted for an important part of the costs of treating hospitalized individuals, especially in cases of cancers and dementia syndromes, with the costs of nutritional therapy superior and greater in the group of users who died.…”

Comparação Entre Três Softwares De Cálculo De Dietas: Uma Análise Do Valor Energético De Uma Dieta Enteral Semiartesanal

“…A TND compreende a Terapia Nutricional Enteral Domiciliar (TNED), Terapia Nutricional Parenteral Domiciliar (TNPD) e Suplemento Oral Domiciliar (SOD) 7 . Sua prática é relevante, uma vez que oferece inúmeras vantagens, com destaque ao ambiente familiar confortável, propiciando um tratamento humanizado, melhor qualidade de vida ao paciente, redução de complicações clínicas e nutricionais, menor chance de reinternações precoces, além de contribuir para redução dos custos hospitalares [7][8][9] .…”