title: Costs of patients under nutritional therapy: from prescription to discharge.
abstract: OBJECTIVE
  This review will discuss the financial cost of the decisions taken regarding the nutritional therapy of hospitalized patients compared with those treated at home. To facilitate comprehension, the authors present a concise introduction to the general concepts of economic health studies, including a glossary of technical terms.
  
  
  RESULTS
  From a revision of the literature, economic aspects are underscored involving the cost of malnutrition, the maintenance of work in a nutritional support team, the use of nutritional therapy in home-care programmes, and in the use of nutritional therapy as a prophylactic action against surgical complications.
  
  
  CONCLUSIONS
  Hospital malnutrition burdens the system financially by provoking a higher rate of surgical complications, mortality and longer hospital stays. Investment in nutritional therapy provides economic returns. The cost of the creation and maintenance of the nutritional support team is easily offset by the resources generated by the team itself. Nutritional therapy in home-care is highly advantageous. In Brazilian trials, groups of surgical patients receiving nutritional therapy within the integrated hospital-home model demonstrated a cost 2.6 times less than the conventional group (exclusively intra-hospital treatment). The adoption of preoperative immunomodulatory nutritional therapy in patients undergoing elective surgery as a prophylactic against postoperative surgical complications presented a 2.24 times reduction in the total treatment cost. The search for the ideal model of nutritional therapy is based on the binomial of quality and cost. The prescription of nutritional therapy has a favourable impact on financial and resource-generating aspects of the institution, when practised by properly trained groups.
authors.affiliation: Gastroenterology Department, University of São Paulo Medical School, R. Maestro Cardim 1175, São Paulo, CEP 01323.001, Brazil. dan@ganep.com.br
authors.forename: Dan L
authors.initials: DL
authors.lastname: Waitzberg
authors.forename: Yara Carnevalli
authors.initials: YC
authors.lastname: Baxter
mesh_terms: D003362:Cost-Benefit Analysis; D016638:Critical Illness / Q000191:economics / Q000628:therapy*; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D009748:Nutrition Disorders / Q000150:complications / Q000628:therapy*; D044623:Nutrition Therapy / Q000191:economics*; D011183:Postoperative Complications