Malnutrition is a condition where patients are under nourished due to disease or ageing. It is prevalent in today’s modern world affecting a significant proportion of the population. The numbers are worrying, 25% of patients in hospital are malnourished, while 30% of elderly people living at home are either malnourished or at risk of malnutrition.

So, what are the implications of malnutrition? Malnutrition complicates an already existing disease, while poses a higher risk for infections.  It also results in longer stays in the hospital and increases death rates. Older people that are malnourished are at a higher risk for falls, for frailty and present a reduced rate of activity and independence.

All these implications are placing an additional burden on healthcare systems. It is estimated that malnutrition costs 170bio€ per year to European countries. A malnourished patient costs 3 times more vs a well nourished patient.

The good news is that malnutrition is preventable and nutritional interventions can reverse negative implications and ultimately save money for healthcare systems. Early nutritional intervention with dietetic counselling can reduce complication rates, readmission rates, length of hospital stay, cost of care and mortality.

The provision of dietetic advice and nutritional supplements reduce complications such as infections and wound by 70% and mortality by 40%. It has been demonstrated that for every 1€ spent on dietary counselling society gets a net return of 14€ to 63€. In hospital patients for every 1€ spent for dietetic therapy, the benefit to society is 3€ -22.6€.

According to the World Economic Forum and Harvard School of Public Health, chronic diseases already pose an immense economic burden which is expected to rise substantially due to the ageing population. For example the cost of cardiovascular disease is estimated to jump from 863 bio$ to 1.04 trillion$ by 2030. With the documented preventive role of nutrition on disease, it is an imperative to reduce cost of illness through nutritional interventions.

Healthcare systems are under increasing economic pressure. Managing malnutrition and integrating clinical nutrition in the healthcare setting can be a cost-effective strategy.

• Define the prevalence and cost of malnutrition and apply health economics analysis for nutritional intervention in the local context. Leverage existing data and best practices from other countries
• Engage with governmental payer bodies and policy makers to build awareness on the issue and activation for its solution
• Develop a recovery plan entailing screening programs, nutritional resourcing of the hospital sector, nutritional supplements availability just to name a few

References

• Medical Nutrition Industry. Malnutrition: A condition that affects 33 million people. 2020
• British Specialist Nutrition Association. Forgotten not Fixed: A Blueprint to Tackle the Increasing Burden of Malnutrition in England. February 2018
• The European Federation of the Associations of Dieticians. Sustainable Health Through the Life Span. Nutrition as a Smart Investment for Europe. October 2019
• Cost-benefit analysis of dietary treatment. SEO Economic Research. Marloes Lammers, Lucy Kok. November 2012
• The Global Economic Burden of Non-communicable Diseases. A report by the World Economic Forum and the Harvard School of Public Health. September 2011

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