title: Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators.
abstract: OBJECTIVE
  In most health care organizations there is still insufficient awareness for recognizing and treating malnourished patients. To gain more insight into nutritional care policies in Dutch health care organizations, this study investigated screening, treatment, and other quality indicators of nutritional care.
  
  
  METHODS
  In 2007 a cross-sectional multicenter study was performed that included 20 255 patients (hospitals, n = 6021; nursing homes, n = 11 902; home care, n = 2332). A standardized questionnaire was used to study nutritional screening and treatment at the patient level and quality indicators at institutional and ward levels (e.g., malnutrition guidelines/protocols, nutritional education, and weighing policy).
  
  
  RESULTS
  Nutritional screening was performed more often in nursing homes (60.2%) than in hospitals (40.3%) and home care (13.9%, P < 0.001). In general, one in every five patients was malnourished, and nutritional treatment was applied in fewer than 50% of all malnourished patients in nursing homes, hospitals, and home care. At ward level nursing homes focused more on the quality of nutritional care than did hospitals and home care, especially with respect to controlling the use of nutritional guidelines (54.6%, P < 0.03), weighing at admission (82.9%, P < 0.01), and mealtime ambiance (91.8%, P < 0.01).
  
  
  CONCLUSIONS
  This large-scale study shows that malnutrition is still a considerable problem in one of every five patients in all participating health care settings. It furthermore demonstrates that recognizing and treating malnutrition continues to be problematic. To target the problem of malnutrition adequately, more awareness is needed of the importance of nutritional screening, appropriate treatment, and other nutritional quality indicators.
authors.affiliation: Department of Health Care and Nursing Science, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands. j.meijers@zw.unimaas.nl
authors.forename: Judith M M
authors.initials: JM
authors.lastname: Meijers
authors.forename: Ruud J G
authors.initials: RJ
authors.lastname: Halfens
authors.forename: Marian A E
authors.initials: MA
authors.lastname: van Bokhorst-de van der Schueren
authors.forename: Theo
authors.initials: T
authors.lastname: Dassen
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006699:Home Care Services / Q000592:standards*; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000592:standards*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011787:Quality of Health Care; D011795:Surveys and Questionnaires