The cost associated with disease-related malnutrition in Ireland

Abstract

Objective: The present study aimed to establish the annual public expenditure arising from the health and social care of patients with diet-related malnutrition (DRM) in the Republic of Ireland. Design: Costs were calculated by (i) estimating the prevalence of DRM in health-care settings derived from age-standardised comparisons between available Irish data and large-scale UK surveys and (ii) applying relevant costs from official sources to estimates of health-care utilisation by adults with DRM. No attempt has been made to estimate separately the costs of DRM and any associated disease, since each can be a cause or consequence of the other. The methods used are adapted from an evaluation of the cost of malnutrition in the UK by the British Association for Parenteral and Enteral Nutrition (2009). Settings: Hospitals, nursing homes, out-patient clinics, primary-care clinics and home care. Subjects: All adult patients receiving hospital in-patient, out-patient or specified community health-care services. Results: The annual public health and social care cost associated with adult malnourished patients in Ireland is estimated at over h1?4 billion, representing 10 % of the health-care budget. Most of this cost arises in acute hospital or residential care settings (i.e. 70 %), with nutritional support estimated to account for ,3 % of spend. Conclusions: The cost associated with the care of patients with DRM is substantial and may rise as the proportion of older people within the population increases, a group at increased risk of DRM. Despite growing pressure on health-care budgets, little attention has been focused on the economic burden associated with DRM in Ireland or the potential for savings arising from improved detection and treatment of those at risk.

The economic cost of hospital malnutrition in Europe; a narrative review

“…Except one study conducted in a Gastroenterology Ward [7] all the others were multidisciplinary [6,7,10,13,15,18,23e25]. For nutritional status, one study used the NRI [15], one the SGA [7], four the NRS-2002 [6,13,18,24], two the Malnutrition Universal Screening Tool (MUST) [23,25] and one used Body Mass Index (BMI) and weight loss [10]. Most malnutrition rates ranged from 19 [7] to 44% [10], with the exception of the Croatian study, which reported a much lower prevalence (3.37%) [24].…”

“…Most selected studies reported additional costs, defined as the extra cost involved in treating all malnourished patients in the general population compared to treating the same number of wellnourished individuals [6,7,10,13,18,23,25]. Five studies reported overall costs [10,15,23e25], and four studies reported detailed costs (hospital, diagnosis, therapies and medications costs) [6,7,13,15,18].…”

“…In the United Kingdom, the annual health care cost of DRM for hospitalized patients was about 3.7 billion £ (4.7 billion V) and the additional cost was almost 3 billion £ (3.8 billion V). In Ireland, the annual total public health and social care costs of malnutrition were estimated at 1.4 billion V (10% of the national health care budget) in all healthcare settings, of which 72 million V (5%) were attributed to hospitalized patients with DRM [23]. In the Netherlands, the total additional costs (prevention, diagnostic, therapy, rehabilitation and care of the disease or treatment under consideration) of DRM were estimated at 1.9 billion V (2.1% of the national health expenditure), of which 1.2 billion V (66%) were attributed to hospital settings [10].…”

Frecuencia de riesgo de desnutrición según la Escala de Tamizado para Desnutrición (MST) en un servicio de Medicina Interna

“…Las más reconocidas son la Valoración Global Subjetiva (SGA, por su nombre en inglés) y la Evaluación Mini Nutricional (MNA) 8,11,12 ; no obstante, su aplicación toma un tiempo apreciable 13,14 . Otras son de más fácil aplicación: a destacar, la MNS-SF (Mini Nutritional Assesment-short form) es una herramienta validada que consta de 6 ítems, sin embargo, incluye una medida antropométrica (el índice de masa corporal) o en su defecto la circunferencia de la pantorrilla (MNA-SF modificada), para lo cual se requiere de personal entrenado e instrumentos.…”

Malnutrition in hospitalised older adults: A multi-centre observational study of prevalence, associations and outcomes

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Malnutrition is common in older adults, and is associated with high healthcare costs and adverse outcomes, particularly in hospital settings (1,2) . The prevalence and correlates of malnutrition in hospitalised older adults are currently not clear; much of the existing research in this area is limited methodologically; studies are typically based on small samples and/or narrow populations (3,4) , exclude people with dementia (3,4) , are uni-centre (5) , and/or use tools not designed for use with older adults (5) .

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