Economic Study in Surgical Patients of a New Model of Nutrition Therapy Integrating Hospital and Home vs the Conventional Hospital Model

• Published in: JPEN. Journal of parenteral and enteral nutrition 2005-01, Vol.29 (1_suppl), p.S96-S105
• Main Authors: Baxter, Yara Carnevalli, Dias, Maria Carolina G., Maculevicius, Janete, Cecconello, Ivan, Cotteleng, Bernard, Waitzberg, Dan Linetzky
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Clinical death. Palliative care. Organ gift and preservation; Cost-Benefit Analysis; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Female; Home Care Services - economics; Hospitalization - economics; Hospitalization - trends; Humans; Intensive care medicine; Length of Stay - economics; Male; Medical sciences; Middle Aged; Nutritional Support - economics; Retrospective Studies
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/01486071050290S1S96

Background: Dehospitalization is a trend in the health sector justified by humanitarian and socials aspects for the patient and relatives. From the financing institutions’ perspective, whether government or third party, the positive results arise from an optimization of hospital bed use and favorable cost-benefit ratio. The “integrated home-hospital” model was created with the purpose of optimization of resources without detriment to the patients’ nutritional care. The objective of this study was an economic evaluation regarding nutrition therapy of the integrated hospital-home model in comparison with an exclusively hospital model. Methods: A retrospective controlled study, paired (age, sex, disease, and surgical procedure), was performed on 56 digestive surgery patients divided into 2 groups: study (SG; n= 30) and control (CG; n= 26). The data collected included total expenses with hospitalization, nutritional benefits, minimization cost analysis, cost-effectiveness ratio analysis, cost-benefit ratio analysis, hospital length of stay, and hospital-bed optimization. Results: The patients from the SG achieved the same nutritional benefits as those in the CG, but with expenses 3 times lower (median Brazil Reals (R)$3237.18 vs R$8647.93; p< .05). The new model resulted in economic benefit to the institution, as shown by the cost-effectiveness ratio, mainly resulting from the savings of the days of hospitalization avoided. The cost-benefit ratio showed an important savings per patient for the institution (US $3100). Conclusions: The home-hospital model also reduced length of hospital stay 2.7 times and optimized the hospital bed usage, as it promoted higher hospital-bed rotation (3 times greater). (Journal of Parenteral and Enterai Nutrition 29:S96-S105, 2005)