Cost-effectiveness of the hospital nutrition screening tool CIPA

Abstract

A b s t r a c t Introduction: Hospital malnutrition is very common and worsens the clinical course of patients while increasing costs. Lacking clinical-economic studies on the implementation of nutrition screening encouraged the evaluation of the CIPA (Control of Food Intake, Protein, Anthropometry) tool. Material and methods: An open, non-randomized, controlled clinical trial was conducted on patients admitted to internal medicine and general and digestive surgery wards, who were either assigned to a control (standard hospital clinical care) or to an intervention, CIPA-performing ward (412 and 411, respectively; n = 823). Length of stay, mortality, readmission, in-hospital complications, and quality of life were evaluated. Cost-effectiveness was analysed in terms of cost per quality-adjusted life years (QALYs). Results: The mean length of stay was higher in the CIPA group, though not significantly (+ 0.95 days; p = 0.230). On the surgical ward, more patients from the control group moved to critical care units (p = 0.014); the other clinical variables did not vary. Quality of life at discharge was similar (p = 0.53), although slightly higher in the CIPA group at 3 months (p = 0.089). Patients under CIPA screening had a higher mean cost of € 691.6 and a mean QALY gain over a 3-month period of 0.0042. While the cost per QALY for the internal medicine patients was € 642 282, the results for surgical patients suggest that the screening tool is both less costly and more effective. Conclusions: The CIPA nutrition screening tool is likely to be cost-effective in surgical but not in internal medicine patients.

The effect of therapeutic exercise in the prevention of lymphoedema secondary to breast cancer: a systematic review

“…The benefits of physical activity in cancer patients are multifaceted; they have been observed in cancer prevention, mortality, and quality of life [24]. Thus, the majority of studies included exercise as a therapy to decrease BCRL symptoms; however, few studies suggest a preventive approach to the disease [18][19][20][21][22][23][24][25]. Based on the obvious need to develop preventive measures, the aim of the present review was to determine the efficacy of therapeutic exercise in the prevention of lymphoedema evaluated through cirtometry, volumetry, or bioimpedance spectroscopy (BIS) of the upper limb (UL) in women after breast cancer removal surgery.…”

Evaluation of the activity and medical nutrition therapy types used by nutrition support teams in hospitals in the Greater Poland voivodeship

“…computer programs supported by artificial intelligence (AI)) for analysis of the nutrition of patients and for assessment of the use of nutritional interventions. What is more, the tools introduced to support nutritional work are not always economically beneficial [ 1 – 5 ].…”

Comparison of Clinical Outcomes in Surgical Patients Subjected to CIPA Nutrition Screening and Treatment versus Standard Care

“…The detailed study protocol and cost-effectiveness analysis have been published elsewhere (the overall study included patients admitted to internal medicine as well as surgical patients). Here, we present the clinical outcomes observed in surgical patients [21,22].…”

“…Assuming that such implementation would improve clinical variables and cost-effectiveness, a secondary objective was to promote the use of nutrition screening in other hospitals. Evaluating the economic aspect, we observed that, in addition to improving quality-adjusted life years, the implemented CIPA screening in surgical patients did save costs compared to usual clinical practices [22]. This work presents all the clinical findings in these patients in detail.…”