Relationship of Malnutrition and Length of Stay in the Hospital

Abstract

LEARNING OUTCOME: To examine the relationship between malnutrition, average length of stay, and hospital costs.Recent studies have suggested that malnutrition may increase average length of stay (ALOS) and thereby increase medical costs. A retrospective chart review of 150 randomly selected cardiac patients was performed to assess this possible relationship and to investigate if early nutrition intervention can eliminate/reduce hospital costs. Subjects were classified into levels of malnutrition by utilizing albumin, total lymphocyte count, percent ideal weight, and percent weight loss. Results indicated a 67% prevalence of malnutrition. Severely malnourished subjects had a five day longer ALOS than adequately nourished subjects, however, across all groups this was not statistically significant, F(2,138)=2.267, (p>.05). In terms of nutrition intervention, subjects who received early nutrition intervention (⩽4 days) had a five day shorter ALOS compared to those who received late nutrition intervention (⩾5 days), however, this was not statistically significant, F(2,138)=12.61, (p>.05). The five day difference in ALOS was substantial in increasing medical costs. A potential patient day savings of 5179,028 for the total sample could have been captured if malnutrition was treated in the hospital stay and nutrition intervention initiated early. Overall, malnutrition still exists in hospitals and costs may be reduced by improving nutrition practices to identify and treat malnutrition early in the stay.