Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

摘要

Background and aims: As policy-makers assess the value of money spent on health care, research in the field of health economics is expanding rapidly. This review covers a period of 10 years and seeks to characterize the publication of papers at the intersection of health economics and nutrition. Methods: Relevant publications on nutrition care were identified in the medical literature databases using predetermined search criteria. These included nutritional interventions linked to health economic terms with inclusion criteria requiring original research that included clinical outcomes and cost analyses, subjects’ ages ≥18 years, and publications in English between January 2004 and October 2014. Results: Of the 5,646 publications identified in first-round searches, 274 met the specified inclusion criteria. The number of publications linking nutrition to economic outcomes has increased markedly over the 10-year period, with a growing number of studies in both developed and developing countries. Most studies were undertaken in Europe (39%) and the USA and Canada (28%). The most common study setting was hospital (62%) followed by communityoninstitutional care (30%). Of all the studies, 12% involved the use of oral nutritional supplements, and 13% involved parenteral nutrition. The economic outcomes consistently measured were medical care costs (53% of the studies), hospital length of stay (48%), hospital readmission rates (9%), and mortality (25%). Conclusion: The number of publications focused on the economics of nutrition interventions has increased dramatically in recent years. Studies have demonstrated that malnutrition can increase the costs of care and length of hospital stay while corresponding studies show that nutrition interventions can help lower the cost of health care by decreasing the incidence of complications and speeding recovery. As populations age, policies that lead to wider adoption of screening, assessment, and treatment of malnutrition will be important to improve health economic outcomes.