Health insurance or subsidy has universal advantage for management of hospital malnutrition unrelated to GDP.

Autor: Klek S; Stanley Dudrick's Memorial Hospital, General Surgery Unit, Poland. Email: klek@poczta.onet.pl; st.klek@gmail.com., Chourdakis M; School of Medicine, Aristotle University of Thessaloniki, Greece., Abosaleh DA; Nutrition Services Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia., Amestoy A; Maestría en Nutrición, Universidad Católica del Uruguay, Montevideo, Uruguay., Baik HW; DMC BundangJesaeng Hospital, Seohyundong, Bundang, Gyeong Gi-Do, Seoul, Republic of Korea., Baptista G; Universidad Central de Venezuela, Facultad de Medicina, Unidad Soporte Nutricional Hospital Universitario de Caracas., Barazzoni R; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy., Fukushima R; Teikyo University School of Medicine, Tokyo, Japan., Hartono J; Intensive Care Unit, Central Army Gatot Soebroto Hospital, Jakarta, Indonesia., Jayawardena R; Diabetes Research Unit, Faculty of Medicine, University of Colombo, Sri Lanka., Garcia RJ; Universidad de las Ciencias Médicas de La Habana, Hospital Universitario Pediátrico Juan Manuel Márquez, La Habana, Cuba., Krznaric Z; School of Medicine, University of Zagreb, Croatia., Nyulasi I; Department of Nutrition and Dietetics and Department of Medicine, Monash University Central Clinical School, Prahran, Australia., Parallada G; Universidad Católica del Uruguay Dámaso Antonio Larrañaga, Montevideo, Uruguay., Francisco EM; St. Luke's Medical Centre, BGC, Taguig, Manila, Philippines., Panisic-Sekeljic M; Medical Academy University Clinic for General Surgery Department for perioperative nutrition, Belgrade, Serbia., Perman M; Intensive Care Unit, Italian Hospital of Buenos Aires, Buenos Aires, Argentina., Prins A; Mary Medical Centre in Groenkloof, Pretoria, South Africa., Del Rio Requejo IM; Hospital Lic. Adolfo LópezMateos ISSSTE, Nutrition and Metabolic Unit, México City., Reddy R; Care Hospitals Banjara Hills, Hyderabad, India., Singer P; Institute for Nutrition Research and Critical Care Department, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel., Sioson M; Section of Nutrition, Department of Medicine, The Medical City Hospital, Pasig City, Manila, Philippines., Ukleja A; Department of Gastroenterology at Cleveland Clinic Florida, Tampa, USA., Vartanian C; Serhal Hospital, Head of Clinical Nutrition and Dietetics Department, Beirut, Lebanon., Fuentes NV; School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile., Waitzberg DL; Departamento de Gastroenterologia da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil., Zoungrana SL; La Clinique de l'Amitié à Ouagadougo, Burkina Faso., Galas A; Jagiellonian University Medical College, Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Krakow, Poland.
Jazyk: angličtina
Zdroj: Asia Pacific journal of clinical nutrition [Asia Pac J Clin Nutr] 2017 Mar; Vol. 26 (2), pp. 247-254.
DOI: 10.6133/apjcn.122015.07
Abstrakt: Background and Objectives: Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings.
Methods and Study Design: An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition (PEN) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and PN.
Results: The prevalence of malnutrition was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and PN were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor PN use depended on GDP, but was associated with increased use of EN and PN in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for PN (p=0.019).
Conclusions: A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.
Databáze: MEDLINE