Skip to main content Skip to main navigation menu Skip to site footer
Articles
Published: 03-06-2022

Relationship between Expenses on Nutritional Therapy and Mortality Rate in Public Hospitals in Salvador, Bahia: An Ecological Study

Medicine Faculty, Health Science School, Universidade Salvador (UNIFACS), Salvador, BA, Brazil
Medicine Faculty, Health Science School, Universidade Salvador (UNIFACS), Salvador, BA, Brazil
Nutrology Service of the General Surgery Unit, Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
Nutrology Service of the General Surgery Unit, Complexo Hospitalar Universitário Professor Edgard Santos (HUPES), Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
nutrition therapy health expenses public hospitals mortality

Abstract

Nutritional therapy (NT) is a set of procedures that maintain or recover the nutritional status. In hospitals, there is a prevalence of 15% to 60% of cases of malnourishment. Malnutrition is related to an increase in infections, immune system dysfunction, longer hospital length of stay and higher mortality. Therefore, a multidisciplinary nutrition therapy team (MNTT) is indispensable. There are gaps regarding the impact of these procedures. The present study aims to analyze the relationship between the expenses on NT and the mortality rate in public hospitals in the city of Salvador, Bahia, Brazil. The present is an ecological study, and data were collected from the Computer Sciences Department of the Brazilian Unified Health System (DATASUS, in Portuguese), regarding the expenses on enteral nutritional therapy (ENT) and parenteral nutritional therapy (PNT) and the mortality rate in public hospitals, from January 2008 to December 2018. The analyses were developed to enable the determination of the exposure associated with the health indicator studied through the adjustment of the curves. The expenses on NT correlated with the mortality rate were represented as a geometric regression curve, revealing a negative β coefficient (-0.3648), showing an inversely proportional relationship (p = 0.0096). For the expenses on ENT, a geometric regression was evidenced, revealing a negative β coefficient (-1.8790), demonstrating an inversely proportional relationship (p = 0.0034). The expenses on PNT evidenced a logarithmic regression, revealing a negative β coefficient (-9824,7295), but with no statistical significance (p = 0.4767). Hospitals that do not provide NT have shown a growth tendency regarding the mortality rate. We concluded that the implementation of a MNTT in public hospitals seems to reduce the mortality rate in the hospital.

Metrics

Metrics Loading ...

References

  1. Brasil. Resolução - RCD n° 63, de 6 de julho de 2000. Diário Oficial da União. Brasília; 2000
  2. Corrêa PH, Shibuya E. Administração da Terapia Nutricional em Cuidados Paliativos. Rev Bras Cancerol 2007; 53 (03) 317-323
  3. Brasil. Manual de terapia nutricional na atenção especializada hospitalar no âmbito do Sistema Único de Saúde – SUS. Brasília: Ministério da Saúde; 2016: 60
  4. Rosa TCA. Indicadores de qualidade da terapia nutricional em unidade de terapia intensiva. Universidade Federal de Mato Grosso do Sul; 2014
  5. Meijers JMM, Halfens RJG, van Bokhorst-de van der Schueren MA, Dassen T, Schols JM. Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators. Nutrition 2009; 25 (05) 512-519
  6. De Lima AM, Gamallo SMM, Oliveira FLC. Desnutrição energético-proteica grave durante a hospitalização: Aspectos fisiopatológicos e terapêuticos. Rev Paul Pediatr 2010; 28 (03) 353-361
  7. Hyeda A, Costa ÉSMD. Economic analysis of costs with enteral and parenteral nutritional therapy according to disease and outcome. Einstein (Sao Paulo) 2017; 15 (02) 192-199
  8. Cardoso AL. A participação do nutrólogo na escolha de dietas especiais. J Pediatr (Rio J) 2004; 80 (05) 343-344
  9. Waitzberg DL, de Aguilar-Nascimento JE, Dias MCG, Pinho N, Moura R, Correia MITD. Desnutrición y terapia nutricional en hospitales y en domicilios en Brasil. Estrategias para aliviarlo: posicionamiento. Vol. 34. Nutricion Hospitalaria. Grupo Aula Medica S.A.; 2017: 969-975
  10. Teixeira LB, Luft VC, Beghetto MG, de Mello ED. A competência dos profissionais em identificar a desnutrição hospitalar. Rev Bras Nutr Clin. 2003; 18 (04) 173-177
  11. Brasil. Portaria SAS no 131 de 08 de março de 2005. Diário Oficial da União. Brasília; 2005
  12. Barker LA, Gout BS, Crowe TC. Hospital malnutrition: Prevalence, identification and impact on patients and the healthcare system. Vol. 8, International Journal of Environmental Research and Public Health. Multidisciplinary Digital Publishing Institute (MDPI); 2011: 514-527
  13. Lim SL, Ong KCB, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr 2012; 31 (03) 345-350
  14. Delegge MH, Kelly AT. State of nutrition support teams [Internet]. Vol. 28, Nutrition in Clinical Practice. SAGE Publications Inc.; 2013. [cited 2020 Mar 3]. p. 691–7. Available from: http://doi.wiley.com/10.1177/0884533613507455
  15. Hassell JT, Games AD, Shaffer B, Harkins LE. Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial. J Am Diet Assoc 1994; 94 (09) 993-998
  16. Morán López JM, Piedra León M, Beneítez Moralejo B, Enciso Izquierdo FJ, Luengo Pérez LM, Amado Señaris JA. Efficiency, cost-effectiveness and need of inversion in nutritional therapy. Importance of detecting and documenting undernutrition. Clin Nutr ESPEN 2016; 13: e28-e32
  17. Waitzberg DL, Correia MI. Strategies for High-Quality Nutrition Therapy in Brazil. JPEN J Parenter Enteral Nutr 2016; 40 (01) 73-82
  18. Smith PE, Smith AE. High-quality nutritional interventions reduce costs. Healthc Financ Manage 1997; 51 (08) 66-69 [Internet]
  19. Correia MITD, Laviano A. Cost-effectiveness of nutrition therapy. Vol. 50, Nutrition. Elsevier Inc.; 2018: 109-111
  20. Cangelosi MJ, Auerbach HR, Cohen JT. A clinical and economic evaluation of enteral nutrition. Curr Med Res Opin 2011; 27 (02) 413-422

How to Cite

Oliveira, B. M. G., Coêlho, L. A. V., Figueiredo, P. C. M. de, & Pimentel, R. F. W. (2022). Relationship between Expenses on Nutritional Therapy and Mortality Rate in Public Hospitals in Salvador, Bahia: An Ecological Study. International Journal of Nutrology, 13(1), 24–30. https://doi.org/10.1055/s-0040-1714137