title: [Costs analysis system; its location within a program for food, nutrition and metabolic intervention].
abstract: Every medical surgical action implies costs. Costs of medical provisions should be translated into tangible, and thus, measurable, benefits for the health status of the patient. Nutritional support therapies might increase the costs of medical provisions, but it is expected their implementation to result in lower morbidity and mortality rates as well as shortening of hospital stay, all of them leading to important savings. It is then required the assimilation of tools for costs analysis for a better management of nutritional support therapies. A proposal for the design of a hospital system (regarded anywhere in this text as SHACOST) for the analysis of the costs of interventions conducted in a patient in accordance with the guidelines included in the Metabolic, Nutrient and Food Intervention Program (referred everywhere for its Spanish acronym PRINUMA) is presented in this article. Hence, strategies are described to estimate the costs of a specified intervention. In addition, a primer on cost-effectiveness (ACE) and incremental cost-effectiveness (ACEI) analyses is shown relying on examples taken from the authors's experience in the provision of nutritional care to patients electively operated for a colorectal cancer. Finally, costs of surgical treatment of a mandibular tumor are described, followed by a discussion on how a better impact of the adopted surgical action could be achieved without considerable increases in total costs should a perioperatory nutritional support program be included. Implementation of SHACOST can provide the medical care teams with accounting tools required to assess the effectiveness of hospital nutritional support schemes, decide whether to acquire and introduce new technologies, and measure the impact of the performance of hospital forms for provision of nutritional care upon health management and perceived quality of life of the patient and their relatives.
authors.affiliation: Especialista en costes. Hospital Clínico quirúrgico "Hermanos Ameijeiras".. ssergito@infomed.sld.cu.
authors.forename: Ileana Sonia
authors.initials: IS
authors.lastname: Fernández Hernández
authors.affiliation: Grupo de Apoyo Nutricional. Hospital Clínico- Quirúrgico "Hermanos Ameijeiras", Cuba.. ssergito@infomed.sld.cu.
authors.forename: Sergio
authors.initials: S
authors.lastname: Santana Porbén
mesh_terms: D015179:Colorectal Neoplasms / Q000601:surgery; D003362:Cost-Benefit Analysis; D005502:Food / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D008339:Mandibular Neoplasms / Q000601:surgery; D009017:Morbidity; D009026:Mortality; D009752:Nutritional Status; D018529:Nutritional Support / Q000191:economics*; D013514:Surgical Procedures, Operative / Q000009:adverse effects