Assessment of the Effectiveness and Cost-effectiveness of an Intervention in Hospitalised Patients with Disease-related Malnutrition.
Call for tender for project: Grants for health research and development projects 2019: Promotion of health research
Funding body: Department of Health, Basque Government
Record no.: 2019111043
PI: Susana García
Funding awarded: €40,022
Description: The assessment and treatment of nutritional status is an area that must be given priority in our healthcare system, and which will help to generate and integrate the knowledge required to improve how the needs of the system and of society are met. The type of project submitted is included in: Promotion of health research. Type: b) Healthcare services research projects. The thematic area is Diabetes, Obesity and Endocrine Diseases, and it also tackles the following topics of section 3) Decision-making Help: (i) Decision-making, and (ii) Equality, Efficacy, Effectiveness and Efficiency.
Objective: Assess the effectiveness and cost-effectiveness of three hospitalised patient healthcare strategies in relation to disease-related malnutrition (DRM) based on results such as days of stay of the index admission, and assessment of the mortality rate, complications, changes in nutritional status, quality of life related to health and functional status, re-admissions, use of health resources (GP visits, hospital and A&E visits), as well as costs arising from the process.
Study design: Three public hospitals with three branches are taking part in the intervention. After nutritional screening in all hospitals, the first branch/hospital includes an intervention strategy to improve nutrition in patients with DRM or at risk of suffering from DRM, and monitoring of the rest of patients; a second cohort/hospital will include similar patients where, if there is nutritional intervention, it will be carried out on demand by the doctors caring for each patient; and a third branch/hospital where the centre’s usual practice will be followed without any specific intervention.
1,000 patients in each hospital admitted in digestive services (with liver or digestive pathologies) and surgery services(with tumours and digestive pathologies). Socio-demographic and clinical data will be collected for all patients, as well as the parameters described above while they are in hospital and for a year whilst they are being monitored. By means of multiple regression models that are appropriate to each result variable and with adjustments using propensity scores to compare the three hospitals according to each result parameter. A cost-effectiveness analysis will be carried out by means of the incremental cost per Quality Adjusted Life Years (QALY) measured by the EuroQol-5d-5l questionnaire.
Results: The project aims to be of interest to the health system: the “Patient Safety Strategy 2020” published on 25 June 2012 by the Department of Health of the Basque Government includes a section on best practice with hospitalised patients at risk of malnutrition, which sets out the goals of establishing nutritional screening when admitted, and designing actions aimed at various risk groups.
Roles: Kronikgune – Project Coordinator