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西班牙医院营养不良的临床和经济影响。

Clinical and financial implications of hospital malnutrition in Spain.

机构信息

Clinical Nutrition Services, Clínica Universidad de Navarra, Pamplona, Spain.

Pharmacy Services, Clínica Universidad de Navarra, Pamplona, Spain.

出版信息

Eur Eat Disord Rev. 2019 Nov;27(6):581-602. doi: 10.1002/erv.2697. Epub 2019 Jul 17.

Abstract

OBJECTIVE

The aim of this review is to analyse the studies about cost and clinical implications that malnutrition causes in the Spanish hospitals.

MATERIAL AND METHODS

The review of the literature was carried out through a bibliographic search in Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and analyse the cost of treatment of malnourished and anorexia nervosa (AN) patients RESULTS: Seventeen studies with economic data related to malnutrition were included. The employment of a nutritional screening is the first tool to determinate the prevalence. Malnutrition is related to an incremental cost due to a longer hospital stay, expensive treatment, and higher rate of readmissions. Malnourished patients present more clinical complications, more infections, and higher mortality. No studies were found with economic data of AN in Spain.

CONCLUSIONS

The prevalence of malnutrition is over 20%, with the elderly patients being the most affected. Nutritional screening is not implanted in all Spanish hospitals in spite of its proven cost-effectiveness. The cost and the clinical implications of malnutrition make this disease a health national problem. The knowledge of the real cost of AN treatment would increase the interest of public institutions on the development of specific Nutritional Screening tools for an early detection of AN.

摘要

目的

本综述旨在分析营养不良在西班牙医院造成的成本和临床影响的研究。

材料与方法

通过在 Web of Science 中按照系统评价和荟萃分析的首选报告项目(PRISMA)标准进行文献回顾,分析营养不良和神经性厌食症(AN)患者治疗成本的相关研究结果。

结果

共纳入 17 项与营养不良相关的经济学数据研究。营养筛查的应用是确定患病率的第一个工具。营养不良与住院时间延长、昂贵的治疗和更高的再入院率有关,导致增量成本。营养不良患者更容易出现临床并发症、感染和更高的死亡率。未发现有关西班牙 AN 经济数据的研究。

结论

营养不良的患病率超过 20%,老年患者受影响最大。尽管营养筛查具有成本效益,但并非所有西班牙医院都采用这种方法。营养不良的成本和临床影响使其成为一个全国性的健康问题。了解 AN 治疗的实际成本将增加公共机构对开发特定营养筛查工具以早期发现 AN 的兴趣。

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