Abstract

Objective: Malnutrition is a condition that increases morbidity and mortality in patients, prolongs hospital stay, and increases treatment costs. The incidence of malnutrition remains a major problem in hospitalized patients despite improvements in nutritional support therapies. Previous studies have shown that treatment standardization can be achieved by using a multidisciplinary team that consists of doctors, pharmacists, nurses, and dieticians, which positively affects hospital costs and patients’ health. In this study, we aimed to investigate the effect of nutritional support teams on treatment cost in our hospital.

Methods: A nutrition support team was established in April 2017 at our hospital and all patients who consulted the team between April 2017 and December 2018 were investigated retrospectively. In this period, the patients were evaluated for incidence of mortality, body mass index, changes in NRS-2002 score, enteral and parenteral nutrition rates, nutritional changes, and annual enteral and parenteral product costs and the effect of multidisciplinary nutrition on these parameters was assessed. Results of quantitative variables were defined as mean, median, and standard deviation. Qualitative variables were represented by frequency and percentage.

Results: A total of 511 patients were enrolled in the study. The mean age of the patients was 68.6 years (18–99) and 49.5% of them were female. Out of 511 subjects, 251 patients were hospitalized in intensive care units and 260 were in wards. Enteral nutrition was recommended in 275 patients, oral nutrition in 71 patients, and parenteral nutrition in 70 patients. The mortality rate was 61.6% in high-risk patients with an NRS2002 score >5 and 38.4% in moderate-risk patients with a score of 3–5. A total of 164 patients who received inappropriate parenteral nutrition were switched to oral or enteral nutrition. The NRS-2002 score was maintained in 267 patients and was decreased in 202 patients. The number of patients receiving parenteral nutrition was 8783 in 2016, which decreased to 6104 in 2018 with a decreasing rate of 30.5%. The number of patients receiving enteral nutrition were 4376 in 2016, which increased to 7582 in 2018 with an increasing rate of 42.2%. The total cost of enteral and parenteral products was decreased.

Conclusion: Giving the nutritional support to malnourished patients or those at high risk of malnutrition could have positive effects on many parameters such as reduction the NRS-2002 scores and hospital costs and choosing the correct nutritional route.

Keywords: Cost effectiveness, malnutrition, nutrition therapy, nutritional, support