The economic impact of disease-related malnutrition at hospital admission
Abstract
Background & aims The reported frequency of disease-related malnutrition (DRM) for patients admitted to hospitals has been shown to be high, but an accurate estimate of the magnitude of its economic costs is lacking. The objective of this study was to determine the impact of DRM on hospitalization costs. Methods A probabilistic sample of 469 (50%) patients from two hospitals was recruited on a cross-sectional study. DRM was evaluated by the Nutritional Risk Screening-2002 instrument at hospital admission and hospitalization costs were calculated for each patient based on hospital length of stay and on the discharge diagnosis-related group (DRG) code. Estimates of the association between DRM and deviations from the mean cost within each DRG were carried out. Results Patients classified as nutritionally-at-risk accounted for 42% of the sample. Multivariate estimates of the determinants of cost deviation shows that the cost of treating a nutritionally-at-risk patient is 20% higher than the average of the respective DRG. Patients that are classified on DRG classes that have a higher relative weight are less likely to end up with hospitalization costs above the mean. Conclusions Considering this sample case-mix, DRM can represent an increase in costs of 19.3%, or between 200 and 1500 euros, with a confidence of 95%.
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Undernutrition has been linked to negative impacts on morbidity, hospital stay duration, quality of life, health care costs, and mortality.
“Undernutrition has been linked to negative impacts on morbidity, hospital stay duration, quality of life, health care costs, and mortality [16,20,21,22,23].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [21]
At least one-third of admitted adult patients are malnourished.
“The prevalence of undernutrition among older adults, patients with various chronic diseases, and hospitalized patients has continued to increase over time, with at least one-third of admitted adult patients being malnourished [16,17,20,21,22,23].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [21]
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- Authors
- Amaral, T. F., Matos, L. C., Tavares, M. M., Subtil, A., Martins, R., Nazaré, M., & Sousa Pereira, N.
- Affiliations
- Universidade do Porto (PT)
- Corresponding author
- Amaral, Teresa F.
- Matos, Luís C.
- Tavares, Maria M.
- Subtil, Ana
- Martins, Rosário
- Nazaré, Margarida
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 26
- Issue
- 6
- Pages
- 778-784
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W1968253147
- Cited by
- 220
- References
- 31
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 2 · 2022: 10 · 2021: 11 · 2020: 16 · 2019: 10 · 2018: 10 · 2017: 12 · 2016: 22 · 2015: 15 · 2014: 23 · 2013: 18 · 2012: 20
- FWCI
- 10.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Funders
- Universidade do Porto
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- disease-related malnutrition, hospital costs, hospitalization, NRS-2002, diagnosis-related groups, length of hospital stay, cost deviation, hospital case mix
- MeSH terms
- Age Factors, Aged, Cross-Sectional Studies, Diagnosis-Related Groups, Female, Hospitalization, Humans, Insurance, Health, Reimbursement, Length of Stay, Male, Mass Screening, Middle Aged, Nutritional Status, Portugal, Quality of Health Care, Risk Factors, Severity of Illness Index, Sex Factors, Nutrition Assessment, Comorbidity, Multivariate Analysis, Case-Control Studies, Hospital Costs, Malnutrition
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