Malnutrition among people with chronic diseases costs $15.5 billion in additional healthcare spending per year, according to a new study.
The report, published this week in the journal Plos One, found individual states face $25 million to $1.7 billion per year in healthcare spending as a result of malnutrition.
More than one-third of patients admitted to the hospital are malnourished or become malnourished during their inpatient stay, the report notes. The condition is difficult to diagnose because it's hard to recognize, especially among obese individuals. The development of malnourishment during a hospital stay can occur because patients are too sick or weak to eat properly, the study adds.
Malnourished patients cost about 20% more to treat on average because it can cause longer length of stays and hospital readmissions, said Scott Goates, lead author of the study and a health economist at pharmaceutical company Abbott Laboratories.
Goates, along with others from Abbott and the University of Illinois, looked at malnutrition costs associated with eight chronic conditions by using data from 2009 to 2014 from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Surveys, which assess the health and nutritional status of adults and children in the U.S.
The eight conditions studied were stroke, chronic obstructive pulmonary disease, coronary heart failure, breast cancer, dementia, musculoskeletal disorders, depression and colorectal cancer. All of the diseases are frequently associated with malnutrition, Goates said.
The report found dementia is the greatest contributor to costs associated with malnutrition, accounting for more than $8.7 billion annually. Goates said this may be the case because dementia is a more costly disease and it's prevalent among older populations. “Providers and caregivers can be more aware of the role nutrition plays in the quality of life for people with dementia and ensure that proper support is available,” he added.
The Medicare population also contributes greatly to malnourishment spending. Although Medicare beneficiaries make up 14% of the population, they account for 28%, or $4.3 billion, of total spending on malnourishment. Goates said because older adults have more chronic illnesses, they contribute more to the cost. He added that about half of older adults admitted to the hospital are malnourished.
Some states also spend more on costs associated with malnourishment than others. At $65 per person or $44 million per year, Washington D.C. spends the most per person on medical costs related to malnutrition. The lowest spending state per person was Utah. The state spends about $36 per person, equaling $109 million per year.
Efforts to address malnourishment have begun at some hospitals, Goates said. He pointed to Cleveland Clinic Akron (Ohio) General, which implemented a formalized process that screens patients for malnutrition upon admission and then administers proper dietary treatment throughout their stay. The hospital saw reductions in length of stays, readmission rates and cost.
But Goates added there is more hospitals can do throughout a patient's stay and after they leave to decrease malnourishment, including collaborating with staff and working with patients. “Implementing high-quality nutrition protocols into all hospitals and empowering patients and healthcare professionals to work together on addressing malnutrition is a key step,” he said.