‘Institutional’ neglect of nutrition leads to costly hospital stays

The irony about nutrition is that something so essential to life is the one most neglected.

In the field of medicine and healthcare in particular, the subject of nutrition is almost always the last, and the least, to be discussed.

Take for example what Dr. Jose Rodolfo V. Dimaano Jr., Abbott Nutrition Philippines’ medical director, shared with the press about nutrition education in the Philippines: “When I was at med school, we didn’t have a subject called nutrition. It was assumed that nutrition would be easy—something one could study on his or her own (The school assumed that nutrition was part of biochemistry). But biochemistry deals with processes and formulas, with no real practical applications. Now we realize, looking back, that nutrition is such a fundamental part of medical intervention.”

There is hope for nutrition as a serious topic for study in the country. Dimaano observed that, though the Philippines lags far behind other nations “in terms of nutritional support in medical institutions, awareness is already starting.”

Key role

For one hospital, at least, nutrition has played a key role in treating (and even reversing) one of the country’s leading killers: heart disease.

Three years ago, a plant-based nutrition protocol called CHIP (Complete Health Improvement Program) was introduced in Adventist Medical Center Manila (Manila Sanitarium) to 30 participants who suffered varying levels of heart disease. After a 30-day treatment period using CHIP, a significant reduction of lipid levels was measured, to the extent that some of the test patients who were scheduled to go under the knife for lipid-related heart problems didn’t require the operation afterward.

Nowhere is the relevance of nutrition vis-à-vis health and hospital care more pronounced than in the malady characterized by the very lack of it: malnutrition.

Malnutrition, according to experts, is a life-threatening yet undertreated problem among patients confined in hospitals. Groups at highest risk of malnutrition include the elderly, as well as those suffering from cancer and digestive disorders.

Today, at least one in three people are malnourished when they are admitted to the hospital, and are even more malnourished when they leave, leaving them more susceptible to poor outcomes, including increased length of stay, healthcare costs, complication rates, readmission rates and mortality. This was cited in the Journal of the American Dietetic Association, (Coats KG, et al., 1993), Nutrition (Giner M, et al., 1996). The American Journal of Clinical Nutrition (Thomas DR, et al., 2002), and Journal of the American Dietetic Association (Braunschweig C, et al., 2000) and presented during a recent Abbott Nutrition press conference at Edsa Shangri-La Hotel in Mandaluyong City.

Benefits

Another published study (American Journal of Managed Care, February 2013) was shared during the press conference, showing benefits associated with patients provided with oral nutritional supplements during hospitalization. The benefits included a 21-percent (2.3 days) reduction in the length of stay and a 21.6-percent ($4,734) reduction in patient hospitalization cost.

There was also a 6.7-percent reduction in the probability of a 30-day readmission in patients who had at least one known subsequent readmission, and were provided oral nutrition supplements during the previous hospitalization.

This study analyzed more than one million adult hospital cases conducted by health economists and supported by Abbott.

Dr. Marianna Sioson, president of the Philippine Society for Parenteral and Enteral Nutrition, shared the relevance of oral nutritional supplements at ground level. “Some patients need to bring up their nutritional levels, and sometimes no matter what we do their poor appetites don’t change,” she said.

Sioson said: “For cancer patients, the constant, long-lasting unpleasant taste in their mouths as a result of chemotherapy and radiation is one of the most debilitating side effects. I have had patients going into depression because of this. It’s a downward spiral. So one way to pull them out of that is to strengthen them with oral nutritional supplements. It’s easy for them. They just gulp it down and they’re done.”

“Oral nutritional supplements is good news for the 4 out of 10 hospitalized Filipino patients who are nutritionally at-risk, since most of them shoulder their hospital expenses out of their own pockets,” she added.