title: Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial.
abstract: OBJECTIVE
  To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management.
  
  
  METHODS
  A quasi-experimental study was conducted over a 7-month period.
  
  
  METHODS
  A 400-bed community hospital.
  
  
  METHODS
  A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study.
  
  
  METHODS
  Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared.
  
  
  METHODS
  Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay.
  
  
  METHODS
  Parametric and nonparametric statistics were used to evaluate outcomes between the two groups.
  
  
  RESULTS
  Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P < .001), and complication rate, which was greater in the nonteam group (P < .001). In the nutrition support team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized.
  
  
  CONCLUSIONS
  Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.
authors.affiliation: Trumbull Memorial Hospital, Warren, OH 44482.
authors.forename: J T
authors.initials: JT
authors.lastname: Hassell
authors.forename: A D
authors.initials: AD
authors.lastname: Games
authors.forename: B
authors.initials: B
authors.lastname: Shaffer
authors.forename: L E
authors.initials: LE
authors.lastname: Harkins
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics* / Q000451:nursing; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay; D009026:Mortality; D010348:Patient Care Team / Q000191:economics*; D010359:Patient Readmission; D011336:Probability; D012720:Severity of Illness Index; D016896:Treatment Outcome