The Billion-Dollar Health Care Problem That Doesn't Have To Be
Health care spending continues to put pressure on the health of the American economy. Nearly one of every five dollars we spend goes toward health care. In a little over a decade, health care will consume one of every three dollars.
Consequently, hospitals are looking for ways to reduce costs – and simultaneously improve patient care. Fortunately, new research shows that there's a simple way to do both: make it standard to screen and treat all patients at risk for malnutrition in hospitals.
Malnutrition, which occurs when someone doesn't consume enough calories, protein or the right mix of vitamins and nutrients, is shockingly common. Up to one-third of patients who are admitted into hospitals are malnourished or at risk of malnutrition. Even more become malnourished during their stay.
Malnutrition takes an enormous toll on patient health and well-being. Nutrient-deprived patients are twice as likely to develop infections as well-nourished ones. They also lose muscle faster, heal slower and are more vulnerable to surgery complications.
Such complications lead to longer hospital stays and, in severe cases, death. Malnourished people spend an extra six days in the hospital – and are three times more likely to pass away.
Malnutrition is also a big economic burden. Malnourished patients utilize a lot more health care resources. Their average hospital stay costs more than $21,000 – nearly double the average tab for well-nourished patients.
That's just for the first visit. Malnourished patients are 50 percent more likely to return to the hospital within 30 days of leaving. This second visit will cost another $16,200.
In total, malnutrition costs the U.S. government $157 billion every year.
Screening and treating patients for malnutrition would bring these costs down and get patients back on their feet faster.
Right now, 10 patients with malnutrition go undiagnosed in the hospital every minute. So millions of patients do not get the treatment they need. But screening is quick and non-invasive. In fact, health care professionals can screen for malnutrition risk in the same amount of time it takes to measure a patient's blood pressure.
Research confirms that screening patients for their risk of malnutrition – and taking simple steps to address it at admission and post-discharge – can drastically improve patient health and save money.
The Cleveland Clinic - Akron General Hospital in Ohio, for example, completed nutrition screenings within 24 hours of patients' admission to the hospital. Using a scientifically tested and validated screening tool, nurses asked patients about any weight loss and their overall appetite. Providing nutritional support to at-risk and malnourished patients cut almost one day off of patients' hospital stays, reduced readmissions by 17 percent and saved nearly $1,000 per patient.
Or consider a comprehensive nutrition program developed by Advocate Health Care and supported by my company, Abbott, at four Chicago-area hospitals with more than 1,200 patients. Nurses used the same validated screening tool to evaluate patients' nutritional status. If a patient was determined to be at-risk or malnourished, the hospital provided immediate nutrition intervention, including drinks for patients with certain diseases. Dietitians and nurses also taught patients and their caregivers about the importance of sticking to these nutrition regimens. After the patients were discharged, the hospital offered nutrition services, including coupons for nutrition supplements and follow-up calls.
The results were astounding. The program shortened hospital stays by two days, lowered readmission rates by 27 percent and yielded cost savings of more than $4.8 million for a six-month period – or about $3,800 per patient.
Programs like these are few and far between. That needs to change. Just like testing for blood pressure, screening for malnutrition risk is quick and easy – and can make a lifelong impact. It's time to embrace this simple way to save billions and help patients live healthier.
Suela Sulo, Ph.D., M.S., is a health outcomes researcher in Abbott's nutrition division.