Pritchard Clive, Duffy Steven, Edington Jackie, Pang Francis
Office of Health Economics, London, England.
JPEN J Parenter Enteral Nutr. 2006 Jan-Feb;30(1):52-9. doi: 10.1177/014860710603000152.
We sought to review the economics literature on enteral nutrition (EN) and oral nutrition supplements (ONS) against the background of an ongoing clinical guideline development.
We searched the Health Economic Evaluations Database, the NHS Economic Evaluation Database, and the Cochrane Database of Systematic Reviews.
Enteral vs parenteral nutrition was found to be the most common comparison undertaken. The randomized trial evidence suggests that, in some groups of patients, EN is better in terms of clinical endpoints and/or length of hospital stay. This should translate into a lower mean cost for EN, given the reduced daily cost. These studies should be treated with caution because of their small sample size and poor quality. Costing was often crude and poorly reported, tending to focus on the narrow costs of the nutrition supplements. Only 1 study of a nutrition supplement in the community setting was found.
There is some evidence to indicate economic advantages of enteral over parenteral nutrition and of immune-enhancing supplements relative to control diet. There is a lack of well-designed studies taking a broad view of relevant comparators, costs, and outcomes. The cost-effectiveness of different forms of nutrition in different patient groups remains to be established.
在持续进行临床指南制定的背景下，我们试图回顾有关肠内营养（EN）和口服营养补充剂（ONS）的经济学文献。
我们检索了卫生经济评估数据库、英国国家医疗服务体系经济评估数据库以及Cochrane系统评价数据库。
发现肠内营养与肠外营养的比较是最常见的。随机试验证据表明，在某些患者群体中，就临床终点和/或住院时间而言，肠内营养更佳。鉴于每日成本降低，这应能转化为肠内营养更低的平均成本。由于样本量小且质量差，这些研究应谨慎对待。成本计算往往粗略且报告不佳，倾向于关注营养补充剂的狭义成本。仅发现一项关于社区环境中营养补充剂的研究。
有证据表明肠内营养相对于肠外营养以及免疫增强补充剂相对于对照饮食具有经济优势。缺乏对相关对照、成本和结果进行全面考量的精心设计的研究。不同形式的营养在不同患者群体中的成本效益仍有待确定。
