Evidence map›Paper›PMID 34244264›Full record

SynthesisBMJ open2021

Cost savings associated with nutritional support in medical inpatients: an economic model based on data from a systematic review of randomised trials.

Philipp Schuetz, Suela Sulo, Stefan Walzer, Lutz Vollmer, Cory Brunton, Nina Kaegi-Braun, Zeno Stanga, Beat Mueller, Filomena Gomes

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 4 countries.

Philipp SchuetzInternal Medicine, Kantonsspital Aarau AG, Aarau, Switzerland schuetzph@gmail.com.ORCID 0000-0002-3799-3742
Suela SuloAbbott Nutrition, Abbott Park, Illinois, USA.ORCID 0000-0002-7567-147X
Stefan WalzerMArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Germany.
Lutz VollmerMArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Germany.
Cory BruntonAbbott Nutrition, Abbott Park, Illinois, USA.
Nina Kaegi-BraunInternal Medicine, Kantonsspital Aarau AG, Aarau, Switzerland.
Zeno StangaInselspital Universitatsspital Bern, Bern, BE, Switzerland.
Beat MuellerInternal Medicine, Kantonsspital Aarau AG, Aarau, Switzerland.
Filomena GomesInternal Medicine, Kantonsspital Aarau AG, Aarau, Switzerland.
Abbott Fund · USKantonsspital Aarau · CHNew York Academy of Sciences · USUniversity Hospital of Bern · CHUniversity of Basel · CHUniversity of Education Weingarten · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsNutritional support improves clinical outcomes during hospitalisation as well as after discharge. Recently, a systematic review of 27 randomised, controlled trials showed that nutritional support was associated with lower rates of hospital readmissions and improved survival. In the present economic modelling study, we sought to determine whether in-hospital nutritional support would also return economic benefits.

methodsThe current economic model applied cost estimates to the outcome results from our recent systematic review of hospitalised patients. In the underlying meta-analysis, a total of 27 trials (n=6803 patients) were included. To calculate the economic impact of nutritional support, a Markov model was developed using transitions between relevant health states. Costs were estimated accounting for length of stay in a general hospital ward, hospital-acquired infections, readmissions and nutritional support. Six-month mortality was also considered. The estimated daily per-patient cost for in-hospital nutrition was US$6.23.

resultsOverall costs of care within the model timeframe of 6 months averaged US$63 227 per patient in the intervention group versus US$66 045 in the control group, which corresponds to per patient cost savings of US$2818. These cost savings were mainly due to reduced infection rate and shorter lengths of stay. We also calculated the costs to prevent a hospital-acquired infection and a non-elective readmission, that is, US$820 and US$733, respectively. The incremental cost per life-day gained was -US$1149 with 2.53 additional days. The sensitivity analyses for cost per quality-adjusted life day provided support for the original findings.

conclusionsFor medical inpatients who are malnourished or at nutritional risk, our findings showed that in-hospital nutritional support is a cost-effective way to reduce risk for readmissions, lower the frequency of hospital-associated infections, and improve survival rates.

Indexed as

InpatientsNutritional SupportCost-Benefit AnalysisCost SavingsHumansModels, EconomicRandomized Controlled Trials as Topichealth economicsnutrition & dieteticspreventive medicine

Identifiers

PMID34244264
PMCPMC8273448
OpenAlexW3179079152

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.