Applied nutritional investigationPREDyCES study: The cost of hospital malnutrition in Spain

- This was a nationwide, case-control study to analyze the economic effects of hospital malnutrition in Spain.
- Patients at nutritional risk had significantly longer hospital lengths of stay and higher costs than patients not at risk.
- Increases in length of stay and costs were particularly important in patients who were not at risk on admission but became at risk during hospitalization.
- Nutritional risk was associated with substantial costs to the Spanish National Health System.
- We suggest that procedures for diagnosing and treating malnutrition in hospitalized patients are needed.

ObjectivesThe aim of this study was to analyze the economic effects of hospital malnutrition and the cost of longer hospital stays according to the Prevalence of Hospital Malnutrition and Associated Costs in Spain (PREDyCES) study data.MethodsThis was a nested case-control study in a prospective cohort of patients (n = 114) who were at nutritional risk at admission and controls (n = 354) who were not at risk at admission. The total cost of hospital stay was the cost of the bed plus the cost of drugs administered during the stay. Hospital costs were extrapolated to Spanish National Health System admissions for 2009.ResultsThe mean hospital length of stay for patients at risk (cases) was significantly longer (11.5 ± 7.5 versus 8.5 ± 5.8 d; P < 0.001) than for the controls. The cost of patients at risk at admission was significantly higher than that of those not at risk (€8590 ± €6127 versus €7085 ± €5625; P = 0.015). The most significant difference in the cost of the hospital stay was observed between controls at nutritional risk at discharge and controls who remained not at risk throughout the hospital stay (€13 013 ± €9086 versus €6665 ± €5091; P < 0.001). Extrapolation of the study findings to Spanish National Health System hospital admissions showed that the potential cost of hospital malnutrition in Spain was at least €1.143 billion per year.ConclusionHospital malnutrition in Spain is associated with substantial costs, suggesting the need to establish procedures for screening, diagnosing, and treating malnutrition.