Trends in the use of feeding tubes in North Carolina hospitals.
OBJECTIVE
National data describing the placement of feeding tubes demonstrated a rapid increase in use in the early and mid-1990s. In the past several years, substantial concerns have arisen regarding the appropriateness of the procedure in many chronically ill patients. The purpose of this study is to determine whether the use of feeding tubes has continued to increase through the 1990s despite these widely publicized concerns.


METHODS
Repeated measure cross-sectional study of the North Carolina Discharge Database.


METHODS
Analyses of all nonfederal hospital inpatient admissions in North Carolina.


RESULTS
We examined the absolute numbers and rates of feeding tube placements from 1989 to 2000. The rate of feeding tube placement increased from 59/100,000 persons in 1989 to 94/100,000 persons in 2000, an overall 60% increase with slowing in the rate of increase in the late 1990s. However, when outpatient procedures were included, the increase in tube feeding continued throughout the 11-year period of observation. The increase was due to an increase in utilization within all hospitals over the time period. Utilization did not differ between profit and not for profit hospitals. The relative growth rate of inpatient feeding tube placement did not differ by age group but the absolute increase was greatest in those age 75 years and over.


CONCLUSIONS
Our study demonstrates that the use of feeding tubes has continued to increase through the 1990s. This increase occurred despite ongoing controversy in the medical literature about feeding tube placement in chronically ill patients.
Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. carmen_lewis@med.unc.edu
Carmen L
CL
Lewis
Christopher E
CE
Cox
Joanne M
JM
Garrett
Laura
L
Hanson
George M
GM
Holmes
Ann
A
Howard
Timothy S
TS
Carey
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D004750:Enteral Nutrition / Q000706:statistics & numerical data* / Q000639:trends*; D006304:Health Status; D006761:Hospitals / Q000639:trends*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data* / Q000639:trends*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D019636:Neurodegenerative Diseases / Q000150:complications / Q000628:therapy; D009657:North Carolina; D020521:Stroke / Q000150:complications / Q000628:therapy