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Szybiński Piotr (Stanley Dudrick's Memorial Hospital, Skawina, Poland), Szczepanek Kinga (Stanley Dudrick's Memorial Hospital, Skawina, Poland), Kłęk Stanisław (Stanley Dudrick's Memorial Hospital, Skawina, Poland)
Home Enteral Nutrition (HEN) - a Complex Cost-Saving Solution to Long-Term Artificial Nutrition
Journal of Health Policy and Outcomes Research, 2013, nr 1, s. 118-125, rys., tab., bibliogr. 44 poz.
Słowa kluczowe
Zdrowie, Choroby, Żywienie człowieka
Health, Illness, Human nutrition
Background: Home enteral nutrition (HEN) was introduced in Poland several years ago. However, the benefits of such medical care have been questioned recently due to the growing costs in the health system. The purpose of this study was to examine the effect of a complex specialized home enteral nutrition on clinical outcome variables in HEN patients. Methods: The observational study included 102 patients (51 women, 51 men, mean age 54.6 years) receiving HEN with homemade diets for at least 12 months before starting a specialized home nutrition program for another 12 months consisting of the provision of commercial enteral formulae and the guidance of a nutrition support team. Both study periods were compared in terms of the number of hospital admissions, length of hospital and intensive care unit stay, and costs of hospitalization. Results: Implementation of the HEN program significantly reduced the number of hospital incidents and the length of hospital admissions and the duration of ICU stay. The need for hospitalization and ICU admission was significantly reduced with odds ratios of 0.083 (95%CI 0.051 to 0.133, P<0.001) and 0.259 (95%CI 0.124 to 0.539, P<0.001) respectively. The specialized HEN was associated with a significant decrease in the prevalence of pneumonia (24.1% vs 14.2%), respiratory failure (7.3% vs 1.9%), urinary tract infection (11.3% vs 4.9%), and anemia (3.9% vs 0%) requiring hospitalization. The mean cost of hospital treatment decreased from 546.18 to 101.69 EURO/year/patient. Conclusions: The specialized HEN care program reduces morbidity and costs related to long-term enteral feeding at home.(original abstract)
Pełny tekst
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