title: Impact of oral nutrition supplements on hospital outcomes in pediatric patients.
abstract: BACKGROUND
  Nutrition deficiency is common among hospitalized children. Although oral nutrition supplements (ONS) may improve malnutrition in this population, the benefits and healthcare costs associated with their use have not yet been fully explored. The objective of this study was to assess the effect of ONS use on inpatient length of stay (LOS) and episode cost in hospitalized children.
  
  
  METHODS
  Retrospective analysis of 557,348 hospitalizations of children aged 2-8 years in the Premier Research Database. The effect of ONS use on LOS and episode cost in a propensity score- matched sample was estimated in analyses with and without the use of instrumental variables (IVs) to reduce confounding from unobserved variables.
  
  
  RESULTS
  ONS were prescribed in 6066 of 557,348 inpatient episodes (1.09%). In IV analysis, using a matched sample of 11,031 episodes, hospitalizations with ONS use had 14.8% shorter LOS (6.4 vs 7.5 days; 1.1 days [95% CI, 0.2-2.4]). Hospitalizations with ONS use had 9.7% lower cost ($16,552 vs $18,320; $1768 [95% CI, $1924-$1612]).
  
  
  CONCLUSIONS
  ONS use was associated with lower LOS and episode cost among pediatric inpatients. ONS use in hospitalized pediatric patients may provide a cost-effective, evidence-based approach to improving pediatric hospital care.
authors.affiliation: Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California dlakdawa@usc.edu.
authors.forename: Darius N
authors.initials: DN
authors.lastname: Lakdawalla
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Maria
authors.initials: M
authors.lastname: Mascarenhas
authors.affiliation: Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Anupam B
authors.initials: AB
authors.lastname: Jena
authors.affiliation: Precision Health Economics, Los Angeles, California.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Vanderpuye-Orgle
authors.affiliation: Precision Health Economics, Los Angeles, California.
authors.forename: Chris
authors.initials: C
authors.lastname: LaVallee
authors.affiliation: Precision Health Economics, Los Angeles, California.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Linthicum
authors.affiliation: Precision Health Economics, Los Angeles, California.
authors.forename: Julia Thornton
authors.initials: JT
authors.lastname: Snider
mesh_terms: D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D010372:Pediatrics; D055656:Prescriptions / Q000191:economics; D012189:Retrospective Studies
keywords: CAM; life cycle; nutrition support practice; outcomes research/quality; pediatrics