Among the individual states, California is paying the highest price, with overall estimated costs at $1.7 billion, while Wyoming spends the least at $25 million.
Per capita spending is highest in Washington D.C. at $65 per person, while Utah spends the least with $36 per person.
“The findings are important to state policy makers and those involved in healthcare decision-making roles focused on reducing healthcare costs,” wrote the authors from Abbott Nutrition and the University of Illinois at Urbana-Champaign.
“Our study is one of the first to quantify the state-level burden of [disease-associated malnutrition]. It comes at a critical time when continued implementation of U.S. healthcare reform provides an opportunity to bring increased awareness to malnutrition-related issues in the healthcare system so they can be addressed and help improve patient health outcomes and lower healthcare costs.”
Obese but malnourished…
Malnutrition occurs when the body doesn’t get the nutrients it needs, but often goes undiagnosed because it can be invisible to the eye. It can occur in both underweight and overweight individuals and data published in the Journal of the American Dietetic Association (200, Vol 100, pp. 1316–1322) indicating that 54% of patients admitted to hospital may be malnourished, with 31% declined nutritionally during their stay. Malnutrition can increase patients’ risk of complications and delay recovery.
The total economic burden (direct & indirect) of disease-associated malnutrition in the US is estimated to be $157 billion each year (Journal of Parenteral and Enteral Nutrition, 2014, Vol. 38, No. 2, Suppl 77S-85S).
“Malnutrition often is unrecognized, particularly in obese individuals which is a growing segment of our population. This is particularly problematic when it accompanies many chronic diseases,” said Dr. Carol Braunschweig, PhD, from the University of Illinois at Chicago and one of the study authors.
“A great deal of research has demonstrated malnutrition negatively impacts health and increases costs to our healthcare system. By emphasizing the importance of nutrition– from identifying and treating people in the hospital to following up with them once they leave – we can improve people’s health and save money in the process.”
The value of nutrition
Nutritional changes have seen promising results, with a recent study, published in the Journal of Nursing Care Quality, reporting reductions in lengths of stay, readmissions and costs of care for patients at Cleveland Clinic Akron General.
“Our healthcare system already spends significant resources treating chronic diseases, and this new study shows how malnutrition – a preventable and treatable condition – is adding to that cost at the state level,” said Scott Goates, PhD, health economist at Abbott and lead study author. “When people are well-nourished, we remove a barrier to successfully managing chronic conditions while lowering the financial burden on individuals and the healthcare system at large.”
“The value of nutrition has been well-established by the scientific community, but we’ve just begun to scratch the surface of applying it into the healthcare setting,” added Goates.
Goates and his co-workers examined the prevalence and cost of treating malnutrition found with dementia, depression, chronic obstructive pulmonary disease (COPD), stroke, musculoskeletal disorders, coronary heart failure (CHF), colon cancer and breast cancer.
Disease prevalence rates were estimated for subgroups defined by age, race and sex using data from the National Health and Nutrition Examination Survey from 2009 to 2014, which was supplemented with National Health Interview Survey data. State prevalence of disease-related malnutrition was estimated by combining national prevalence estimates with states’ demographic data from the U.S. Census. Direct medical cost for each state was estimated as the increased expenditures incurred as a result of malnutrition.
Source: PLoS ONE
Volume 11, Number 9: e0161833. doi:10.1371/journal.pone.0161833
“Economic Burden of Disease-Associated Malnutrition at the State Level”
Authors: S. Goates, K. Du, C.A. Braunschweig, M.B. Arensberg