PAM15 BUDGET IMPACT OF A NUTRITION PROGRAM FOR COMMUNITY-DWELLING PATIENTS AT MALNUTRITION RISK

Abstract

Hospital-based nutrition-focused interventions have been found to alleviate the burden of malnutrition for inpatients due to improved health outcomes (i.e., reduced readmissions and hospital stays). Limited evidence exists on the economic impact of nutrition interventions across the care continuum and for community-based patients. We assessed the potential cost-savings associated with decreased 30-day healthcare resource utilization (i.e., admissions/readmissions, emergency room (ED) and outpatient clinic visits) employing a budget impact analysis of community-dwelling patients at malnutrition risk receiving healthcare services at home. The reduction observed in healthcare resource utilization rate for 1546 patients enrolled in the quality improvement program (QIP) was compared with that of the 7413 pre–QIP historical cohort patients to calculate potential cost-savings. The model calculates differences in the number of 30-day admission/readmissions, ED and outpatient clinic visits observed for QIP vs. pre-QIP historical group and associated total cost reductions. The fixed and variable QIP program costs including 30-day oral nutritional supplements (ONS) costs were included in the analysis. The cost of hospitalization of $17,985 was from the Healthcare Cost and Utilization Project (HCUP) which reported costs for malnourished adult patients using 2016 data for United States hospital admissions. The average costs of ED and outpatient visits of $1,252 and $510.95, respectively were from the 2013 Medical Expenditure Panel Survey (MEPS). Due to improved health outcomes and reduced healthcare resource utilization for the QIP patients over the 30-day timeframe, cost-savings of $2,353,237 total and per patient net-savings of $1,522 were calculated in favor of QIP group as compared to the pre-QIP/historical counterparts. The nutrition-focused QIP resulted in significant healthcare cost-savings by avoiding 30-day admissions/readmissions, ED and outpatient clinic visits. The observed economic improvement highlights the importance of implementing similar nutrition-focused QIPs for at-risk/malnourished patients across the care continuum, and in particular for community-dwelling adults receiving care in post-acute care settings.