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Economic Impact of Malnutrition: A Model System for Hospitalized Patients
Author(s) -
Reilly James J.,
Hull Sam F.,
Albert Nick,
Waller Alger,
Bringardener Scott
Publication year - 1988
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607188012004371
Subject(s) - medicine , malnutrition , parenteral nutrition , complication , enteral administration , pediatrics , retrospective cohort study , emergency medicine , intensive care medicine , surgery
A retrospective review of 771 patients' charts in two acute care hospitals was performed to determine likelihood of malnutrition (LOM) at admission and to assess the effect of LOM on costs and charges. Using accepted criteria, LOM was present in 59 and 48% of medical and surgical patients, respectively. Patients with LOM were 2.6 or 3.4 times as likely to have a predefined minor or major complication, respectively; and 3.8 times as likely to die as patients without LOM (all p < 0.001). In every diagnosis‐related group, the mean length of stay was longer for LOM patients (range 1.1–12.8 excess days). Accountants converted charges to direct variable costs using departmental cost‐to‐charge ratios. LOM status increased excess costs and charges per patient by $1738 and $3557, respectively ( p < 0.0001). When complications occurred, LOM patients incurred $2996 or $6157 excess costs and charges per patient ( p < 0.01). Serum albumin was the strongest clinical predictor of cost. The hospitals' cost of providing enteral or parenteral nutrition support was $18 or $102 per day, respectively. Too few patients received early nutrition support to assess efficacy. Nonetheless, the costs associated with malnutrition warrant early detection and aggressive treatment. (Journal of Parenteral and External Nutrition 12: 371–376, 1988)