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Nutrition-focused care cuts hospitalization risk by nearly 25%

Patients who underwent nutrition-focused care that consisted of malnutrition risk screening and at-home use of oral nutritional supplements reduced their risk for hospitalization by almost 25%, according to findings recently published in the Journal of Parenteral and Enteral Nutrition.

“Identification and treatment of malnutrition across the care continuum can help prevent illness onset or relapse and maximize the effectiveness of other medical treatments,” Katie Riley, RN, of Advocate Health Care in Downers Grove, Illinois, and colleagues wrote.

Researchers assessed hospitalization rates and health care costs after implementation of a nutrition-focused quality improvement program at a home health agency. Patients were screened for malnutrition risk at the first home health agency visit, educated on the importance of nutrition, and provided with a nutrition care plan along with oral nutrition supplements when needed. The intervention group included 1,546 patients at two home health agencies.

Researchers also established two control groups: a historic group that included 7,413 patients at-risk for malnutrition in the prior year at the same two home health agencies; and a concurrent group of 5,235 patients from five home health agencies in the same system who received only screening at the same time the intervention was implemented.

More than 75% of patients from all three cohorts were 65 years of age and older.

Riley and colleagues found that a patient’s relative risk for hospitalization after participating in the program was 24.3% after 30 days, 22.8% after 60 days and 18.3% vs. the historic group, and by 18.2% after 30 days, 16.2% after 60 days and 12.1% after 90 days vs. the concurrent group. In addition, total cost savings from reduced 90-day health care resource utilization was $2,318,894 or $1,500 per patient treated. However, ED visits were higher in the group during the 90-day follow-up period among those who participated in the program (RR = 1.46; 95% CI, 1.27-1.69).

Study co-author Suela Sulo, PhD, of Abbott Research & Development in Columbus, Ohio, explained how primary care physicians can bringing the program utilized in the study into their practices.

“Primary care physicians were informed about their patients’ nutrition treatment regimen after the home health clinician visited the patient. This enabled PCPs to continue having discussions with their patients about their nutritional needs and compliance with treatment regimen,” she told Healio Primary Care.

PCPs are ideally suited to recognize and malnutrition among their older patients, Sulo continued, providing ways to screen these patients for malnutrition that do not inhibit further care.

“Look for things like unintentional weight loss, decreased appetite, recent illness/injury and hospitalization, underlying health issues, tiredness and a lack of energy or strength,” she advised.

Researchers noted that among Medicare beneficiaries, unplanned hospital readmissions cost up to $12 billion annually and that patient readmissions are becoming more commonly used as quality-of-care measures for provider reimbursements. – by Janel Miller

Disclosures: Sulo reports being an employee and stockholder of Abbott. Riley reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.