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

Autor: Toulson Davisson Correia MI; Department of Surgery, Federal University of Minas Gerais, Medical School, and Rede Mater Dei, Belo Horizonte, Brazil., Castro M; Hospital Israelita Albert Einstein, São Paulo, Brazil., de Oliveira Toledo D; Hospital Israelita Albert Einstein, São Paulo, Brazil., Farah D; Women's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.; Axia.Bio Life Sciences, São Paulo, Brazil., Sansone D; Women's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.; Axia.Bio Life Sciences, São Paulo, Brazil., de Morais Andrade TR; Women's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.; Axia.Bio Life Sciences, São Paulo, Brazil., Tannus Branco de Araújo G; Women's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.; Axia.Bio Life Sciences, São Paulo, Brazil., Fonseca MCM; Women's Health Technology Assessment Center, Department of Gynecology, Federal University of São Paulo, Medical School, São Paulo, Brazil.; Axia.Bio Life Sciences, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2021 Sep; Vol. 45 (7), pp. 1542-1550. Date of Electronic Publication: 2020 Dec 21.
DOI: 10.1002/jpen.2052
Abstrakt: 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.
(© 2020 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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