title: COST-EFFECTIVENESS OF EARLY NUTRITIONAL THERAPY IN MALNOURISHED ADULT PATIENTS IN A HIGH COMPLEXITY HOSPITAL.
abstract: BACKGROUND
  hospital malnutrition is a frequent worldwide problem and its potential issues related include increased complications, length of stay, mortality, and healthcare costs.
  
  
  OBJECTIVE
  the aim of this study was to establish the cost-effectiveness of early nutritional therapy for malnourished patients in a high complexity hospital.
  
  
  METHODS
  this analytical study with economic assessment included 227 adult hospitalised and malnourished according to the Subjective Global Assessment. The cohort prospective received Early Nutrition Therapy (ENT), whereas the cohort retrospective received Delayed Nutrition Therapy (DNT). The measures of cost-effectiveness included costs by: length of stay, complications and discharge condition.
  
  
  RESULTS
  the cohorts were similar in demographic and clinical characteristics, except that the median age, for the ENT was 61 years (interquartile range [IQR]: 48-71) and for the DNT was 55 years (IQR: 44-67) (p = 0.024). The median length of stay was lower in the ENT (11 days, IQR: 7-17) than in the DNT (18 days, IQR: 10-28) (p < 0.001). The cost per patient discharged alive was US $ 10,261.55 in the ENT and US $ 15,553.11 in the DNT (p=0.043); the cost per patient with complications was US $ 13,663.90 in the ENT and US $ 17,860.32 in the DNT (p= 0.058). ENT increased the likelihood of being discharged alive, RR adjusted=0.31; 95% confidence interval (CI): 0.1; 0.6; (p<0.001) and decreased the likelihood of complications RR crude=0.8; 95% CI: 0.6; 0.9; (p=0.006).
  
  
  CONCLUSIONS
  early nutritional therapy for malnourished adult patients appears to be cost-effective because it can reduce the length of stay, complications, mortality and associated costs.
authors.affiliation: Universidad de Antioquia. Escuela de Nutrición y Dietética. Grupo de Investigación en Alimentación y Nutrición Humana.. nubia.giraldo@udea.edu.co.
authors.forename: Nubia Amparo
authors.initials: NA
authors.lastname: Giraldo Giraldo
authors.affiliation: mbia Sede Medellín, Facultad de Ciencias Humanas y Económicas, Departamento de Economía.. nubia.giraldo@udea.edu.co.
authors.forename: Johanna
authors.initials: J
authors.lastname: Vásquez Velásquez
authors.affiliation: Hospital Pablo Tobón Uribe.. nubia.giraldo@udea.edu.co.
authors.forename: Paula Andrea
authors.initials: PA
authors.lastname: Roldán Cano
authors.affiliation: Universidad de Antioquia. Escuela de Nutrición y Dietética. Colombia.. nubia.giraldo@udea.edu.co.
authors.forename: Carolina
authors.initials: C
authors.lastname: Ospina Astudillo
authors.affiliation: Universidad de Antioquia. Escuela de Nutrición y Dietética. Colombia.. nubia.giraldo@udea.edu.co.
authors.forename: Yuliet Paulina
authors.initials: YP
authors.lastname: Sosa Cardona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000191:economics* / Q000628:therapy*; D008875:Middle Aged; D044623:Nutrition Therapy / Q000191:economics*; D012189:Retrospective Studies; D055815:Young Adult