Health economic analyses in medical nutrition: a systematic literature review

Walzer, Stefan; Droeschel, D.; Nuijten, Mark; Chevrou‐Séverac, Hélène

doi:10.2147/ceor.s53601

Cited by 12 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A systematic literature search was initiated and executed based on a predefined search protocol following the population, intervention, comparison, and outcomes (PICO) criteria (see also Table 1 ). 17 Following the systematic literature search that was published recently on the health economics evidence in medical nutrition, 18 this study aims to summarize the results of those publications that are related to the value for money of medical nutrition interventions. The research questions upon which this review was conducted can be summarized as follows: “Are medical nutrition interventions value for money in integrated care?…”

Section: Methodsmentioning

confidence: 99%

Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

Walzer¹,

Droeschel²,

Nuijten³

et al. 2014

CEOR

Self Cite

View full text Add to dashboard Cite

BackgroundHealth care decision-makers have begun to realize that medical nutrition plays an important role in the delivery of care, and it needs to be seen as a sole category within the overall health care reimbursement system to establish the value for money. Indeed, improving health through improving patients’ nutrition may contribute to the cost-effectiveness and financial sustainability of health care systems. Medical nutrition is regulated by a specific bill either in Europe or in the United States, which offers specific legislations and guidelines (as provided to patients with special nutritional needs) and indications for nutritional support. Given that the efficacy of medical nutrition has been proven, one can wonder whether the heterogeneous nature of its coverage/reimbursement across countries might be due to the lack of health-related economic evidence or value-for-money of nutritional interventions. This paper aims to address this knowledge gap by performing a systematic literature review on health economics evidence regarding medical nutrition, and by summarizing the results of these publications related to the value for money of medical nutrition interventions.MethodsA systematic literature search was initiated and executed based on a predefined search protocol following the population, intervention, comparison, and outcomes (PICO) criteria. Following the systematic literature search of recently published literature on health economics evidence regarding medical nutrition, this study aims to summarize the results of those publications that are related to the value for money of medical nutrition interventions. The evaluations were conducted by analyzing different medical nutrition according to their indications, the economic methodology or perspective adopted, the cost source and utility measures, selected efficiency measures, as well as the incremental cost-effectiveness ratio.ResultsA total of 225 abstracts were identified for the detailed review, and the data were entered into a data extraction sheet. For the abstracts that finally met the predefined inclusion criteria (n=53), full-text publications were obtained via PubMed, subito, or directly via each journal’s Webpage for further assessment. After a detailed review of the full text articles, 34 publications have been qualified for a thorough data extraction procedure. When differentiating the resulting articles in terms of their settings, 20 studies covered inpatients, whereas 14 articles covered outpatients, including patients in community centers. When reviewing the value-for-money evaluations, the indications showed that the different results were mostly impacted by the different perspectives adopted and the comparisons that were made. In order to draw comprehensive conclusions, the results were split according to the main indications and diseases.DiscussionThe systematic literature search has shown that there is not only an interest in health economics and its application in medical nutrition, but that there is a lot of ongoing research in ...

show abstract

Section: Methodsmentioning

confidence: 99%

Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

Walzer¹,

Droeschel²,

Nuijten³

et al. 2014

CEOR

Self Cite

View full text Add to dashboard Cite

show abstract

“…Therefore, quality management assessment is a promising initiative to guarantee the effectivity of nutrition treatment and to prevent the discrepancies observed in literature results, which put its efficacy at stake . Some authors have addressed quality assessment of NT, but to our knowledge, none have fully audited the various steps of the process. This would include interviewing administrators and staff members of the NT team (NTT) or assisting personnel and analyzing patients’ medical records to acquire information on how this therapy is being carried out.…”

Section: Introductionmentioning

confidence: 99%

Implementing Quality Assessment Is Fundamental to Guarantee Optimal Nutrition Therapy

Gomes

Silva

Ferreira

et al. 2019

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Introduction The implementation of quality assessment in nutrition therapy (NT) is an important strategy, with the potential to contribute to the reduction of malnutrition and improve the cost‐effectiveness of NT. Studies on this subject are scarce in the world. Our objective was to evaluate the practice of NT in hospitals located in the third‐most‐developed state of Brazil. Methods A cross‐sectional study, using data collected through interviews with members of the clinical staff/interdisciplinary NT team (NTT) and audits of clinical protocols and medical records, was carried out. Both non–probability and probability sampling techniques were used to select the hospitals. Results Thirty‐three hospitals were included (10 public, 10 philanthropic, 9 private, and 4 university). Twenty‐six institutions reported to have an NTT. There was no statistically significant difference in the existence and performance of the teams or in the presence of protocols and quality indicators between the types of hospitals. However, the inspection of 172 medical records showed that essential items for the nutrition care of the patient were not fully in agreement with the previous provided information, and this varied according to the type of hospital. Conclusion The majority of hospitals had an NTT as well as protocols and quality indicators. However, patient records were not in accordance with the essential items to guarantee NT quality and safety, indicating a gap between theory and practice.

show abstract

“…To give another example, probiotics have been demonstrated to be beneficial in preventing acute upper respiratory tract infections and in reducing the duration of illness episodes ( King et al, 2014 ; Hao et al, 2015 ). Finally, nutrition interventions may also have positive effects in the short term: for example, oral nutritional supplements in malnourished hospitalized patients have repeatedly been shown to be associated with a reduced length of hospital stay and thus cost savings ( Freijer et al, 2014 ; Lakdawalla et al, 2014 ; Walzer et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Nutrition and health technology assessment: when two worlds meet

Poley

2015

Front. Pharmacol.

View full text Add to dashboard Cite

There is a growing recognition that nutrition may have a positive impact on public health and that it may reduce medical expenditures. Yet, such claims need to be substantiated by evidence. This evidence could be delivered by health technology assessment (HTA), which can be thought of as the evaluation of technologies for clinical effectiveness, cost-effectiveness, and ethical, legal, and social impacts. The application of HTA to the field of “nutrition interventions” is recent. So far, HTA and nutrition have represented two worlds far apart in many respects. This contribution, roughly, addresses the following issues: is there a need for HTAs in the field of nutrition, what would such HTAs look like, and how can the results coming from these HTAs optimally aid policy making?In essence, HTAs of nutrition have much of the same basic principles and structure as HTAs of “classical” health care treatments. Nevertheless, there are challenges to rigorous HTAs of nutrition interventions, for various reasons. To mention a few: the evidence base for nutrition interventions is less well developed than that for many health care treatments. Furthermore, it is a matter of debate which outcome measures should be used in HTAs of nutrition. For example, one may argue that nutrition not only has health effects, but also effects that are not captured by traditional health-related quality of life measures (e.g., the pleasure of eating, effects relating to ease of use, or effects on well-being).HTAs in the field of nutrition may deliver information valuable to a wide range of stakeholders, including consumers/patients, health professionals, hospital administrators, insurers, and decision makers. The results of HTAs are typically used in making treatment guidelines, in informing decisions about reimbursement or about public health campaigns, etc. Yet, it is uncertain how the results of HTAs of nutrition can be used optimally. For example, would it be possible to summarize the results of a HTA in a single ratio (such as costs per quality-adjusted life-year gained) and then to either approve or reject the intervention based on this ratio, compared to a certain threshold? Apart from that, in the field of nutrition, it is typically not about reimbursement of a technology. Related to this, it is important that the message from HTAs of nutrition is brought to a range of stakeholders including the general population and that these HTAs are tailored to the decision-making context.To conclude, a growing need is felt for HTA-type evaluations of nutrition, which are sparse these days. Little thought has been given to developing an optimal methodology for HTAs of nutrition and to how its results should be integrated into policy making. Further work in these areas would stimulate the development of nutrition interventions that yield a gain in societal welfare. To achieve this, the two worlds of HTA and nutrition need to be brought together.

show abstract

Health economic analyses in medical nutrition: a systematic literature review

Cited by 12 publications

References 16 publications

Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

Implementing Quality Assessment Is Fundamental to Guarantee Optimal Nutrition Therapy

Nutrition and health technology assessment: when two worlds meet

Contact Info

Product

Resources

About