Nutrition Therapy Cost‐Effectiveness Model Indicating How Nutrition May Contribute to the Efficiency and Financial Sustainability of the Health Systems

Abstract

Background: Malnutrition is highly prevalent in hospitalized patients but seldom recognized and treated. Malnutrition poses several adverse events, such as increased infection rates, length of hospital stay, and mortality, as well as costs. Early nutrition interventions have been shown to decrease the associated malnutrition burdens, leading to relevant savings. Thus, this study aims to evaluate the cost-effectiveness of nutrition therapy, including oral supplements to at-risk or malnourished adult inpatients admitted to the Brazilian Public System (SUS) hospitals. Method: A cost-effectiveness model, encompassing a 1-year period and regarding total costs, length of hospital stay, readmissions, and mortality related to malnutrition, was developed, having the provision of early nutrition therapy as the intervention variable. The number of avoided hospitalization days, prevented hospital readmissions, and prevented deaths defined the effectiveness of the model. All the costs were estimated based on the SUS database. Results: Early nutrition therapy provided to all at-risk or malnourished patients would represent cost-effectiveness of US $92.24, US $544.59, US $1848.12, and US $3698.92, for each day of hospitalization avoided, for additional patients having access to hospitalization, for preventing readmission, and for prevented death, respectively. The highest impact on savings was represented by the mean reduction in the length of hospital stay. Conclusion: Early oral nutrition intervention for patients malnourished or at risk of malnutrition resulted in overall reduced hospital costs. These findings provide a rationale to tackle the implementation of educational programs focusing on the care of inpatients with malnutrition or its risk.

Healthcare Resource Utilization and Cost Comparisons of High-Protein Enteral Nutrition Formulas Used in Critically Ill Patients

“…[20][21][22][23] By reducing LOS, lowering infection rates, and avoiding readmissions, early nutrition therapy targeting malnourished hospitalized patients suggests total healthcare cost savings. 16,24 In the ICU, appropriate nutrition management is vital to avoid potential risks. 25 Given the characteristics and comorbid conditions of our real-world sample, proper choice of high-protein EN is essential.…”

Nutrition care is an integral part of patient-centred medical care: a European consensus

“…Effective cancer control programs and policies should therefore consider economic aspects for all cancer patients, survivors, and their carers [106][107][108][109][110][111]. A poor nutrition status is costly [106,112,113] and nutrition interventions contribute to reduced healthcare costs [112,[114][115][116][117]. On the other hand, the economic cost of malnutrition also impacts the healthcare system due to the costs associated with more complications, increased length of hospital stay (LOS), readmissions and increased morbidity [112].…”

Nutritional Management in Adult Patients With Dysphagia: Position Paper From Japanese Working Group on Integrated Nutrition for Dysphagic People

“…Early provision of ONS to patients at risk for malnutrition is also expected to be costeffective. 42 However, a 2020 systematic review 43 demonstrated that ONS increased protein intake and serum albumin levels in older rehabilitation patients; however, the functional outcome improvements, which were reported in only a few studies, were uncertain. Therefore, supporting evidence for the use of ONS in patients with dysphagia is needed.…”