Impact of the Severity of Disease-Related Malnutrition on Healthcare Resource Utilization in Pediatric Patients 1 Year and Older
Author(s)
Tifanny Istamto, MBA, MSc1, Tini Nguyen, PharmD1, Matias Ricci, MBA2, David Alderson, MBA, MSc2, Thierry Tchoukouaha, MBA2.
1Nutricia Global, Hoofddorp, Netherlands, 2Cogentia Healthcare Consulting, Cambridge, United Kingdom.
1Nutricia Global, Hoofddorp, Netherlands, 2Cogentia Healthcare Consulting, Cambridge, United Kingdom.
OBJECTIVES: Describe the impact of disease-related malnutrition (DRM) on healthcare resource utilisation (HRU) in the paediatric population (1 year and older).
BACKGROUND: DRM occurs when individuals with disease do not consume adequate quantities of quality food from their diet, or do not reach the right levels of nutrients to compensate for the specific nutritional deficiency resulting from disease. DRM is estimated to affect 30% of the Italian hospitalised paediatric population. Failure to treat DRM in children can have long-term consequences into adulthood, including delayed mental development, poor academic, performance, and increased risk of chronic diseases.
METHODS: Structured literature review was conducted to identify abstracts and posters published after 2014. The scope was global. The OvidSP search platform was used, which comprised Embase, Medline, Econlit, PsycINFO, and EBMR. The search covered various conferences pertaining to nutrition, digestive diseases, and Health Economics and Outcomes research.
RESULTS: Six papers showed that HRU increased with malnutrition in chronic diseases including neurological conditions and congenital heart disease.
A multi-centre European study indicated that moderately malnourished children (BMI <-2 to >-3SDs) had 1.3 days longer length of stay (LoS) than well-nourished peers, while severely malnourished children (BMI <-3SDs) had 1.6 days longer LoS.
A US study associated worsening malnutrition with an increase rate of reoperations (p=0.04) and longer median and post-operative LoS (p=<0.01).
A study in China showed a significant association between malnutrition after congenital heart defect surgery with cardiac residual abnormalities, high Ross classification, and long-term oral diuretics usage (OR= 35.3, p<0.0001, p=27.1, p<0.0001, and OR=20.5, p=0.001).
CONCLUSIONS: Paediatric DRM is a major public health concern with serious ramifications for outcomes. Dietary management with medical nutrition is the preferred approach to DRM. More research is needed to understand the full extent of the burden of DRM in the healthcare sector, as well as its broader societal impact.
BACKGROUND: DRM occurs when individuals with disease do not consume adequate quantities of quality food from their diet, or do not reach the right levels of nutrients to compensate for the specific nutritional deficiency resulting from disease. DRM is estimated to affect 30% of the Italian hospitalised paediatric population. Failure to treat DRM in children can have long-term consequences into adulthood, including delayed mental development, poor academic, performance, and increased risk of chronic diseases.
METHODS: Structured literature review was conducted to identify abstracts and posters published after 2014. The scope was global. The OvidSP search platform was used, which comprised Embase, Medline, Econlit, PsycINFO, and EBMR. The search covered various conferences pertaining to nutrition, digestive diseases, and Health Economics and Outcomes research.
RESULTS: Six papers showed that HRU increased with malnutrition in chronic diseases including neurological conditions and congenital heart disease.
A multi-centre European study indicated that moderately malnourished children (BMI <-2 to >-3SDs) had 1.3 days longer length of stay (LoS) than well-nourished peers, while severely malnourished children (BMI <-3SDs) had 1.6 days longer LoS.
A US study associated worsening malnutrition with an increase rate of reoperations (p=0.04) and longer median and post-operative LoS (p=<0.01).
A study in China showed a significant association between malnutrition after congenital heart defect surgery with cardiac residual abnormalities, high Ross classification, and long-term oral diuretics usage (OR= 35.3, p<0.0001, p=27.1, p<0.0001, and OR=20.5, p=0.001).
CONCLUSIONS: Paediatric DRM is a major public health concern with serious ramifications for outcomes. Dietary management with medical nutrition is the preferred approach to DRM. More research is needed to understand the full extent of the burden of DRM in the healthcare sector, as well as its broader societal impact.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
SA53
Topic
Health Service Delivery & Process of Care, Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
Nutrition, Pediatrics