Klek Stanislaw, Chourdakis Michael, Abosaleh Dima Abdulqudos, Amestoy Alejandra, Baik Hyun Wook, Baptista Gertrudis, Barazzoni Rocco, Fukushima Ryoji, Hartono Josef, Jayawardena Ranil, Garcia Rafael Jimenez, Krznaric Zeljko, Nyulasi Ibolya, Parallada Gabriela, Francisco Eliza Mei Perez, Panisic-Sekeljic Marina, Perman Mario, Prins Arina, Del Rio Requejo Isabel Martinez, Reddy Ravinder, Singer Pierre, Sioson Marianna, Ukleja Andrew, Vartanian Carla, Fuentes Nicolas Velasco, Waitzberg Dan Linetzky, Zoungrana Steve Leonce, Galas Aleksander
Stanley Dudrick's Memorial Hospital, General Surgery Unit, Poland. Email:
School of Medicine, Aristotle University of Thessaloniki, Greece.
Asia Pac J Clin Nutr. 2017 Mar;26(2):247-254. doi: 10.6133/apjcn.122015.07.
Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings.
An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition (PEN) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and PN.
The prevalence of malnutrition was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and PN were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor PN use depended on GDP, but was associated with increased use of EN and PN in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for PN (p=0.019).
A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.
