Reber Emilie, Norman Kristina, Endrich Olga, Schuetz Philipp, Frei Andreas, Stanga Zeno
Department for Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, 3010 Bern, Switzerland.
Department of Nutrition and Gerontology, German Institute for Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany.
J Clin Med. 2019 Jul 10;8(7):1005. doi: 10.3390/jcm8071005.
Disease-related malnutrition (DRM) is a highly prevalent independent risk and cost factor with significant influence on mortality, morbidity, length of hospital stay (LOS), functional impairment and quality of life. The aim of our research was to estimate the economic impact of the introduction of routinely performed nutritional screening (NS) in a tertiary hospital, with subsequent nutritional interventions (NI) in patients with potential or manifest DRM. Economic impact analysis of natural detection of inpatients at risk and estimation of the change in economic activity after the implementation of a systematic NS were performed. The reference population for natural detection of DRM is about 20,000 inpatients per year. Based on current data, DRM prevalence is estimated at 20%, so 4000 patients with potential and manifest DRM should be detected. The NI costs were estimated at CHF 0.693 million, with savings of CHF 1.582 million (LOS reduction) and CHF 0.806 million in additional revenue (SwissDRG system). Thus, the introduction of routine NS generates additional costs of CHF 1.181 million that are compensated by additional savings of CHF 2.043 million and an excess in additional revenue of CHF 2.071 million. NS with subsequent adequate nutritional intervention shows an economic potential for hospitals.
疾病相关营养不良（DRM）是一种高度普遍的独立风险和成本因素，对死亡率、发病率、住院时间（LOS）、功能障碍和生活质量有重大影响。我们研究的目的是评估在一家三级医院引入常规营养筛查（NS），并对潜在或明显患有DRM的患者进行后续营养干预（NI）的经济影响。对住院风险患者的自然检测进行了经济影响分析，并估计了实施系统性NS后经济活动的变化。DRM自然检测的参考人群约为每年20000名住院患者。根据目前的数据，DRM患病率估计为20%，因此应检测出4000名潜在和明显患有DRM的患者。NI成本估计为69.3万瑞士法郎，节省了158.2万瑞士法郎（住院时间缩短），并增加了80.6万瑞士法郎的额外收入（瑞士疾病诊断相关分组系统）。因此，引入常规NS产生了118.1万瑞士法郎的额外成本，但通过204.3万瑞士法郎的额外节省和207.1万瑞士法郎的额外收入过剩得到了补偿。NS及随后适当的营养干预对医院具有经济潜力。
