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The cost‐effectiveness of identifying and treating malnutrition in hospitals: a systematic review
Author(s) -
Mitchell H.,
Porter J.
Publication year - 2016
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12308
Subject(s) - medicine , malnutrition , checklist , psychological intervention , health care , systematic review , medline , clinical trial , intensive care medicine , cost effectiveness , family medicine , nursing , risk analysis (engineering) , pathology , political science , law , economics , cognitive psychology , economic growth , psychology
Background Disease‐related malnutrition is known to have significant clinical and economic consequences. This systematic review of recent evidence aimed to establish the cost‐effectiveness of identifying and treating malnutrition in the hospital setting. Methods A search of four electronic databases and the Internet was conducted for relevant publications from 2003 to 2013. The search strategy considered both nutritional care and healthcare costs. Hospitalised adults with, or at risk of malnutrition, were the focus of the review. Eligibility criteria included publications of original research to identify or treat malnutrition through usual care. Studies with a focus on enteral and parenteral nutrition interventions were beyond the scope of the review. Methodological quality was assessed using the Consensus on Health Economic Criteria checklist. Results Of the 1174 records identified through database searching, 19 full‐text articles were assessed for eligibility. Three studies were included in the final review, highlighting the absence of recent high quality cost‐effectiveness studies in this field. One economic modelling study and two prospective clinical trials were included of moderate to high methodological quality. Conclusions Definite conclusions could not be drawn regarding the cost‐effectiveness of individual interventions because of the heterogeneity of treatments, controls and populations. The present review highlights an evidence gap in the care of malnourished hospitalised adults, limiting the ability of clinicians and healthcare managers to make informed, cost‐effective treatment decisions. Further economic evaluations are needed and should be considered as a routine component of future research.