Malnutrition-Related Healthcare Costs in Hospitalized IBD Patients: A Nationwide Real-World Data Analysis in Italy
Author(s)
Chiara Bini, MSc1, Matteo Scortichini, MSc1, Elena Paola Lanati, -2, Valentina Pagella, -2, Paolo Sciattella, MSc, PhD1.
1Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, Rome, Italy, 2LIONHEALTH Srl – Società Benefit, Milan, Italy.
1Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, Rome, Italy, 2LIONHEALTH Srl – Società Benefit, Milan, Italy.
OBJECTIVES: Malnutrition is a major and often underdiagnosed complication of inflammatory bowel disease (IBD), leading to worse clinical outcomes and increased healthcare costs. However, global data on the economic impact of malnutrition in IBD remain limited, and no data are currently available at the Italian level. This study aimed to assess the clinical and economic burden of malnutrition among hospitalized IBD patients in Italy using national administrative data from the Ministry of Health.
METHODS: A systematic literature review was conducted to assess the epidemiological burden of IBD-related malnutrition at the national level. Additionally, a retrospective analysis was performed using the Italian National Hospital Discharge Records (SDO) from 2015 to 2019 to identify patients with a first hospitalization for IBD (Crohn's disease or ulcerative colitis), with or without a diagnosis of malnutrition. Patients were followed for one year to evaluate clinical outcomes (hospital mortality, length of stay, readmissions) and costs based on national DRG tariffs. Comparisons between patients with and without malnutrition were carried out using 1:1 matching for age, sex, region, and Charlson Comorbidity Index.
RESULTS: Among the approximately 250,000 patients with IBD in Italy, the prevalence of moderate-to-severe malnutrition is estimated at 21% (≈52,500), with around 60% of these patients hospitalized annually (≈31,500). The SDO analysis revealed a significant underdiagnosis of malnutrition (only 3.1%). Nonetheless, malnourished patients had a significantly higher in-hospital mortality rate (6.3% vs 4.5%), longer hospital stays (30 vs 16 days), and more annual readmissions (1.26 vs 0.71). The mean hospital cost per malnourished patient was €10,800 compared to €6,800 for non-malnourished patients (+59.9%).
CONCLUSIONS: This study confirms that malnutrition significantly impacts healthcare costs and outcomes in IBD patients in Italy. These findings highlight the need for routine nutritional screening and targeted nutrition interventions within IBD care pathways.
METHODS: A systematic literature review was conducted to assess the epidemiological burden of IBD-related malnutrition at the national level. Additionally, a retrospective analysis was performed using the Italian National Hospital Discharge Records (SDO) from 2015 to 2019 to identify patients with a first hospitalization for IBD (Crohn's disease or ulcerative colitis), with or without a diagnosis of malnutrition. Patients were followed for one year to evaluate clinical outcomes (hospital mortality, length of stay, readmissions) and costs based on national DRG tariffs. Comparisons between patients with and without malnutrition were carried out using 1:1 matching for age, sex, region, and Charlson Comorbidity Index.
RESULTS: Among the approximately 250,000 patients with IBD in Italy, the prevalence of moderate-to-severe malnutrition is estimated at 21% (≈52,500), with around 60% of these patients hospitalized annually (≈31,500). The SDO analysis revealed a significant underdiagnosis of malnutrition (only 3.1%). Nonetheless, malnourished patients had a significantly higher in-hospital mortality rate (6.3% vs 4.5%), longer hospital stays (30 vs 16 days), and more annual readmissions (1.26 vs 0.71). The mean hospital cost per malnourished patient was €10,800 compared to €6,800 for non-malnourished patients (+59.9%).
CONCLUSIONS: This study confirms that malnutrition significantly impacts healthcare costs and outcomes in IBD patients in Italy. These findings highlight the need for routine nutritional screening and targeted nutrition interventions within IBD care pathways.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE570
Topic
Economic Evaluation, Health Technology Assessment, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Gastrointestinal Disorders