title: Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK.
abstract: OBJECTIVE
  To examine the effect of malnutrition on clinical outcomes and healthcare resource use from initial diagnosis by a general practitioner (GP) in the UK.
  
  
  METHODS
  1000 records of malnourished patients were randomly selected from The Health Improvement Network database and matched with a sample of 996 patients' records with no previous history of malnutrition. Patients' outcomes and resource use were quantified for six months following diagnosis.
  
  
  RESULTS
  Malnourished patients utilised significantly more healthcare resources (e.g. 18.90 versus 9.12 GP consultations; p < 0.001, and 13% versus 5% were hospitalised; p < 0.05). The six-monthly cost of managing the malnourished and non-malnourished group was £1753 and £750 per patient respectively, generating an incremental cost of care following a diagnosis of malnutrition of £1003 per patient. Thirteen percent and 2% of patients died in the malnourished and non-malnourished group respectively (p < 0.001). Independent predictors of mortality were: malnutrition (OR: 7.70); age (per 10 years) (OR: 10.46); and the Charlson Comorbidity Index Score (per unit score) (OR: 1.24).
  
  
  CONCLUSIONS
  The healthcare cost of managing malnourished patients was more than twice that of managing non-malnourished patients, due to increased use of healthcare resources. After adjusting for age and comorbidity, malnutrition remained an independent predictor of mortality.
authors.affiliation: Catalyst Health Economics Consultants, Northwood, Middlesex, UK. julian.guest@catalyst-health.co.uk
authors.forename: Julian F
authors.initials: JF
authors.lastname: Guest
authors.forename: Monica
authors.initials: M
authors.lastname: Panca
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Baeyens
authors.forename: Frank
authors.initials: F
authors.lastname: de Man
authors.forename: Olle
authors.initials: O
authors.lastname: Ljungqvist
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wait
authors.forename: Lisa
authors.initials: L
authors.lastname: Wilson
mesh_terms: D002017:Budgets; D003695:Delivery of Health Care / Q000191:economics*; D017048:Health Care Costs; D006295:Health Resources; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000628:therapy*; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D006113:United Kingdom