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Cost and Outcome Analysis of Home Parenteral and Enteral Nutrition
Author(s) -
Reddy Prabashni,
Malone Margaret
Publication year - 1998
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 - 10.1177/0148607198022005302
Subject(s) - parenteral nutrition , medicine , enteral administration , population , quality of life (healthcare) , clinical nutrition , pediatrics , emergency medicine , intensive care medicine , nursing , environmental health
Background: Previous estimates of the cost of home parenteral and enteral nutrition (HPEN) have excluded hospitalization costs or were conducted abroad and have limited applicability in the United States. Few studies have used validated measures to determine the effect of home nutrition support on quality of life. Method: A cost and clinical outcome analysis was performed by retrospective review of charts of patients receiving HPEN from 1991 to 1996. Questionnaires to determine the influence of therapy on lifestyle (n = 41) and a general health status questionnaire, the short form 36‐item survey (n = 39), were mailed to patients. Results: The annual cost per patient for parenteral solutions was $55,193 ± 30,596 (mean ± SD) based on Medicare charges and for enteral tube feedings was $9605 ± 9327. The annual cost of hospitalization ranged from zero to $140,220 in the parenteral nutrition group and from zero to $39,204 in the enteral nutrition group. The annual number of hospitalizations per patient for patients receiving parenteral nutrition ranged from 0.52 to 1.10, compared with 0 to 0.50 in the enteral nutrition population. The health status of HPEN patients was significantly lower (p <.05) in five of the eight short‐form 36 health domains compared with the general population. The areas of lifestyle most frequently affected were travel, sleep, exercise and leisure. Conclusions: The majority of the cost of therapy was associated with the direct provision of nutrition, although in some patients the hospitalization expenditure exceeded this cost. Home nutrition support had a significant negative impact on a patient's quality of life and lifestyle. (Journal of Parenteral and Enteral Nutrition 22: 302–310, 1998)