[Dietary-therapeutic product supply in unitary doses at a university hospital: effect on consumption and costs].
OBJECTIVE
To analyze the consumption and costs of the Enteral Nutrition products (diets and dietary supplements) dispensed from the Nutrition unit in a 735-bed general hospital during two six-month periods, before and after the implementation of a unit-dose (UD) distribution system.


METHODS
The defined daily dose (DDD) methodology was used. A DDD of 1,500 Kcal/day was defined for complete diets in adults, with 1,000 Kcal/day for complete diets in children, 1,200 Kcal/day for "start-up" diets, 500 Kcal/day for normocaloric supplements and 600 Kcal/day for hypercaloric supplements and 450 Kcal for very low caloire diets.


RESULTS
The total consumption in the hospital fell from 10.21 DDD per 100 stays/day (DED in its Spanish acronym), representing generated costs of 8,640,130 pesetas between November, 1997, and April, 1998, to 6.25 DED in the same period for 1998-99, with costs amounting to 6,674,775 pesetas (-23%). In the services handled using UD, the total consumption declined from 9.3 DED between November, 1997, and April, 1998, to 5.2 DED in the same period for 1998-99. The consumption of standard/special diets and dietary supplements went from 1.38/0.76/7.16 DED to 1.48/0.53/3.19 DED during the two periods under study, with an accompanying drop in costs of -1,806,598 pesetas (-30%). In percentage terms, the standard diets varied from 26% to 41% (of the total cost generated in the services with UD), special diets from 28% to 22% and dietary supplements from 54% to 37%. In those services where the UD was not applied (ICU and reanimation), the total consumption of diets remained stable with a slight drop from 25.3 DED to 24.3 DED.


CONCLUSIONS
The unit dose system has improved the prescription of therapeutic dietary products in our hospital and has reduced the costs, mainly through the notable decrease in the dispensation of supplements.
Oliveira Fuster
G
G
Sección de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España. gof@arrakis.es
García García-Doncel
L
L
Carral SanLaureano
F
F
Domenech Cienfuegos
I
I
Arencibia Rivero
T
T
Manzano Martín
M V
MV
D000328:Adult; D002648:Child; D003365:Costs and Cost Analysis; D004750:Enteral Nutrition; D005526:Food, Formulated / Q000191:economics; D006785:Hospitals, University; D006801:Humans; D010607:Pharmacy Service, Hospital; D013030:Spain