OBJECTIVES: Although the treatment of Disease-Related Malnutrition (DRM) reduces rehospitalizations by 27.5% and the average length of stay (ALOS) by 26.1%, the establishment of nutritional treatment at home in Spain is limited by an outdated regulatory framework. The aim of this research is to estimate the financial burden that a possible extension of DRM treatment at home would entail after hospital discharge.

METHODS: A group of chronic diseases/clinical conditions that nutrition experts propose to include in the financing of Home Enteral Nutrition (HEN) was analyzed, when they are associated with severe DRM: severe COPD, New York Heart Association Class III-IV Heart Failure, Child-Pugh C Chronic Liver Disease, Chronic Kidney Disease stage IV, and Pressure ulcers stage III-IV. Target population was estimated from a systematic literature review, prioritizing studies on the Spanish population, and data from official sources. The cost of HEN (Oral Nutritional Supplementation: 400 mL/day for 12 weeks) and hospitalizations was included in the calculation of the net cost per patient. A dissemination rate of 24% (expert opinion) and a time horizon of one year were assumed, from the perspective of the National Health System (NHS).

RESULTS: Per year, 14,096 patients are discharged with these chronic diseases/conditions and severe DRM from Spanish public hospitals. The average cost of the HEN is €742.40/patient, and the cost of hospitalization is €900.56/day. The reduction in rehospitalizations and ALOS in those receiving HEN allows us to estimate a net cost per patient treated with HEN of -€3,240.69. The financing of 24% of these patients would generate savings of almost eleven million euros for the NHS.

CONCLUSIONS: The financing of the HEN in these diseases would have an impact on significant savings for the NHS, even without considering other savings due to a reduction in non-hospital care resources (other medicines, home care).