​New Research: a review of nutrition economics - the vital role of nutrition intervention in malnutrition management

Naberhuis JK, Hunt VH, Bell JD et al (2017) Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care? Nutrition and Dietary Supplements 9:55-62

Nutrition economics can provide a key link between clinical nutrition and health outcomes. This in turn allows for clarity on cost vs benefits for patients, commissioners and society. With scarce resources often available, there is a growing need for such statistics to ensure the best optimisation of these resources.

More and more, nutrition economic studies are showing that nutrition care is a cost-effective way to prevent and treat medical problems for both acute and chronic health conditions. [1] [2]

Given expanding health costs, this recently published paper sought to characterise and compare nutrition economic studies that had been carried out over a 10-year period.

The majority of the studies were conducted in developed countries, with the majority undertaken in Europe (38%) followed by USA and Canada (28%). Many of the studies focused on disease-related malnutrition, defined as the malnutrition that arises as a side effect of other diseases. 62% of the studies reviewed the hospital setting whilst 28% were undertaken in the community or non-institutional care. Of the economic outcomes which were consistently measured, 53% of the studies looked at medical care costs, 48% at hospital length of stay, 9% at hospital readmission rates and 25% at mortality.

Current estimates suggest that malnutrition affects three million people in the UK, with 1.3 million of these being over 65 years of age.[3] This review demonstrated that malnutrition can increase the costs of care and length of stay. Corresponding studies have demonstrated that the correct nutritional interventions can reduce such costs by speeding recovery and reducing the risk of complications. In a recent systematic review, a mean cost saving of 12.2% was shown for those patients receiving oral nutritional supplements in the hospital setting.[4]

Policies need to explore wider implementation of screening, assessment and treatment of malnutrition in order to improve health outcomes – an especially important factor given our aging population.

[1] Freijer K, Bours MJ, Nuijten MJ, et al. (2014) The economic value of enteral medical nutrition in the management of disease-related malnutrition: a systematic review. J Am Med Dir Assoc. 15(1):17–29.

[2] Norman K, Pichard C, Lochs H, Pirlich M. (2008) Prognostic impact of disease related malnutrition. Clin Nutr. 27(1):5–15.

[3] Elia M, BAPEN/NIHR. (2015) The cost of malnutrition in England and potential cost savings from nutritional interventions.

[4] Elia M, Normand C, Norman K, Laviano A. (2016) A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clin Nutr. 35(2):370–380.