title: Economic impact of switching from an open to a closed enteral nutrition feeding system in an acute care setting.
abstract: BACKGROUND
  This study compared an open-system (OS) enteral nutrition (EN) delivery system with a closed system (CS). Factors evaluated included nursing time for administration, patient safety factors, and cost of formula and supplies.
  
  
  METHODS
  This study analyzed the cost of formula and supplies in 1 major academic medical center. Data were collected on patients requiring EN in acute care settings. Information collected included formula type and amount of formula ordered and delivered.
  
  
  RESULTS
  The average daily cost to feed each adult patient using delivered volume with the OS was $3.84 compared with $4.31 if the patient had been receiving EN from a CS. Considering waste costs, the average cost to feed increased to $4.21 compared with $4.80, respectively. After factoring in increased nursing time with the OS, the cost increased to $9.83. For pediatric patients, formula delivery reached 1 L in only 2% of patient days. The average cost to feed each patient each day using actual delivered volume was $1.89 in the OS and $1.94 in the CS. When factoring in the cost of waste, those costs increased to $2.12 and $3.30, respectively. After factoring in increased nursing time with the OS, the cost increased to $8.92.
  
  
  CONCLUSIONS
  Due to the higher contract price and increased waste of the CS formulas compared with the OS formulas, a higher daily average cost for formula delivered may be incurred by switching to a CS. However, the CS is more cost-effective when factoring in nursing time.
authors.affiliation: University of Virginia Health System, Charlottesville, VA 22903, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Phillips
authors.forename: Brandis
authors.initials: B
authors.lastname: Roman
authors.forename: Kendra
authors.initials: K
authors.lastname: Glassman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics*; D004750:Enteral Nutrition / Q000191:economics* / Q000379:methods*; D005526:Food, Formulated / Q000191:economics*; D006801:Humans; D007223:Infant; D009752:Nutritional Status
keywords: adult; costs and cost analysis; enteral formulas; outcome assessment; pediatrics