Dialogue Proceedings: Advancing Patient-Centered Malnutrition Care Transitions

Abstract:

As people age, their health needs are likely to become more complex and impacted by chronic disease, social determinants of health, and nutrition. Good nutrition and a healthy diet are critical in influencing chronic conditions such as hypertension, diabetes, cardiovascular disease, kidney disease, gastrointestinal disorders, cancer, and obesity. Yet all too often, as patients transition from one point of care to another, their nutrition status is not evaluated, documented, or even included in patient health conversations. Beyond the hospital setting, it is rare for care coordination to occur with patients and their families to help prevent or intervene for poor nutrition or malnutrition that includes under-nutrition and over-nutrition.

Lack of sufficient malnutrition recognition and care across settings of care means patients are frequently at risk for developing negative health outcomes related to malnutrition, including increased risk of chronic disease, frailty, falls, and loss of independence. Worsened health outcomes can also result in increased healthcare services utilization. For example, in a longitudinal analysis, hospitalized malnourished patients had up to 100% higher in-hospital costs ($25,200 vs. $12,500) and a 54% higher likelihood of 30-day readmissions compared with non-malnourished patients. Moreover, the US economic burden of disease-associated malnutrition is estimated at $157 billion annually.

Recognizing these challenges, a multi-stakeholder group of health and community leaders and advocates came together on March 14, 2018 for a national Dialogue to focus on developing real-world solutions to better integrate nutrition risk identification and care into existing care transition pathways and accountable care models. The results of their discussion are the basis for these proceedings.

Support for the Dialogue was provided by Abbott.