Abbott Laboratories, Abbott Park, IL, USA.
Agency for Health Economic Assessment and Dissemination GmbH, Lörrach, Germany.
Value Health Reg Issues. 2022 Nov;32:70-77. doi: 10.1016/j.vhri.2022.08.005. Epub 2022 Sep 11.
We assessed the impact of a recently reported nutritional quality improvement program (QIP) on healthcare resource utilization and costs for older, community-living adults in Bogotá, Colombia.
The study included 618 community-dwelling, older adults (> 60 years) who were at risk or malnourished and receiving outpatient clinical care. The intervention was a QIP that emphasized nutritional screening, dietary education, lifestyle counseling, 60-day consumption of oral nutritional supplements, and 90-day follow-up. For economic modeling, we performed 90-day budget impact and cost-effectiveness analyses from a Colombian third-party payer perspective. The base-case analysis quantified mean healthcare resource use in the QIP study population. Analysis was based on mean input values (deterministic) and distributions of input parameters (probabilistic). As the deterministic analysis provided a simple point estimate, the cost-effectiveness analysis focused on the probabilistic results informed by 1000 iterations of a Monte-Carlo simulation.
Results showed that the total use of healthcare resources over 90 days was significantly reduced by > 40% (hospitalizations were reduced by approximately 80%, emergency department visits by > 60%, and outpatient clinical visits by nearly 40%; P < .001). Based on economic modeling, total cost savings of $129 740 or per-patient cost savings of $210 over 90 days could be attributed to the use of nutritional QIP strategies. Total cost savings equated to nearly twice the initial investment for QIP intervention; that is, the per-dollar return on investment was $1.82.
For older adults living in the community in Colombia, the use of our nutritional QIP improved health outcomes while lowering costs of healthcare and was thus cost-effective.
我们评估了最近报道的营养质量改进计划（QIP）对哥伦比亚波哥大社区居住的老年成年人的医疗资源利用和成本的影响。
该研究纳入了 618 名患有营养不良风险或营养不良的社区居住的老年人（>60 岁），他们正在接受门诊临床护理。干预措施是一项 QIP，强调营养筛查、饮食教育、生活方式咨询、60 天口服营养补充剂的使用和 90 天随访。为了进行经济建模，我们从哥伦比亚第三方支付者的角度进行了 90 天的预算影响和成本效益分析。基础分析量化了 QIP 研究人群的平均医疗资源使用情况。分析基于平均输入值（确定性）和输入参数分布（概率性）。由于确定性分析提供了一个简单的点估计，因此成本效益分析侧重于由蒙特卡罗模拟的 1000 次迭代提供的概率结果。
结果表明，90 天内医疗资源的总使用量显著减少了>40%（住院治疗减少了约 80%，急诊就诊减少了>60%，门诊就诊减少了近 40%；P<0.001）。基于经济建模，营养 QIP 策略的使用可节省 129740 美元的总费用或每位患者 210 美元的费用。总节省费用相当于 QIP 干预初始投资的近两倍；也就是说，投资的每美元回报率为 1.82 美元。
对于居住在哥伦比亚社区的老年人，使用我们的营养 QIP 可改善健康结果，同时降低医疗保健成本，因此具有成本效益。
