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Study Shows Nutrition Program Could Result in Hospital Cost Savings

Making sure people stay nourished in the hospital has shown to help patients recover; real-world evidence confirms its cost benefits, too. The research, published in the journal American Health & Drug Benefits and supported by Abbott, found that when Advocate Health Care implemented a nutrition care program at four of its Chicago-area hospitals, it showed more than $4.8 million in cost savings due to shorter hospital stays and lower readmission rates.

Addressing malnutrition is a growing concern, as one in three people enter the hospital malnourished or at risk of malnutrition. Decades of research prove that when patients are poorly nourished, their recovery is impacted, including higher risk of complications (eg, pressure ulcers, infections, and falls) and more frequent readmissions. Studies also show that poor nutrition can result in increased costs of care and longer hospital stays—with the average hospital stay costing nearly $2,000 per day. As a result, hospitals and health care systems, such as Advocate Health Care, are looking at the value of nutrition to improve care and help patients get back to living a healthier life.

Advocate's goals follow the current general trend of health care. Population health management and value-based care being current targets in health care, hospitals and health care systems are promoting patient health not only at the hospital but also at home. Theoretically, if patients are armed with information and motivation, they'll be more empowered to improve their health in all areas of their lives, reducing both health care and personal costs.

Starting in 2014, Advocate Health Care implemented two models of a nutrition care program for patients at risk of malnutrition, and the results from this study published in December 2016 found that doing so reduced 30-day readmission rates by 27% and the average hospital stay by nearly two days.

One iteration of the program, undertaken at two area hospitals, included EMR-prompted malnutrition screenings by nurses and administration of dietary supplements to patients who needed them. An enhanced version of the program was implemented at two other hospitals and comprised in-house patient education, dietary guidance for patients to follow postdischarge, follow-up phone calls, and coupons for supplements. Each program took place at one teaching hospital and one community hospital.

To evaluate the cost savings of this program, researchers used a novel web-based budget impact model to assess the potential cost savings from the avoided readmissions and reduced time in the hospital. Compared with the hospitals' previous readmission rates and patients' average length of stay, researchers found that optimizing nutrition care in the four hospitals resulted in a savings of roughly $3,800 per patient treated for malnutrition.

"Value-based care means looking comprehensively at patient care to identify gaps and opportunities for improvement," says Lee Sacks, MD, executive vice president and chief medical officer of Advocate Health Care. "The study's findings demonstrate that modest changes in the way we care for patients, such as ensuring patients are nourished during their hospital stay, can have a big impact in reducing costs and improving health outcomes."

The study authors recommend that other health care organizations moving toward value-based care also consider researching the effect of preventive measures such as nutrition education and malnutrition screening for the benefit of patients and hospitals and health care systems alike.

"This research confirms that implementing nutrition-focused quality improvement programs, like the ones at Advocate Health Care, can help patients recover from their hospitalization faster while also removing some of the burden of financial pressures placed on health systems today," says Suela Sulo, PhD, a health outcomes researcher at Abbott and lead author of the cost impact study. "As providers, administrators, and payers face added pressures from rising health care costs, value-based nutrition interventions should be considered in all hospitals across the United States."

— Source: Abbott; Advocate Health Care
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