Can Oral Nutritional Supplements Improve Medicare Patient Outcomes in the Hospital?

Darius Lakdawalla, Snider Julia Thornton (), Perlroth Daniella J., LaVallee Chris, Linthicum Mark T., Tomas Philipson, Partridge Jamie S. and Wischmeyer Paul E.
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Snider Julia Thornton: Precision Health Economics, Los Angeles, California, USA
Perlroth Daniella J.: Center for Primary Care Outcomes Research, Stanford University, Stanford, California, USA
LaVallee Chris: Precision Health Economics, Austin, Texas, USA
Linthicum Mark T.: Precision Health Economics, Los Angeles, California, USA
Partridge Jamie S.: Health Economics and Outcomes Research, Abbott Nutrition, Columbus, Ohio, USA
Wischmeyer Paul E.: Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA

Forum for Health Economics & Policy, 2014, vol. 17, issue 2, 131-151

Abstract: We analyzed the effect of oral nutritional supplement (ONS) use on 30-day readmission rates, length of stay (LOS), and episode costs in hospitalized Medicare patients (≥65), and subsets of patients diagnosed with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia (PNA). Propensity-score matching and instrumental variables were used to analyze ONS and non-ONS episodes from the Premier Research Database (2000–2010). ONS use was associated with reductions in probability of 30-day readmission by 12.0% in AMI and 10.1% in CHF. LOS decreases of 10.9% in AMI, 14.2% in CHF, and 8.5% in PNA were associated with ONS, as were decreases in episode costs in AMI, CHF and PNA of 5.1%, 7.8% and 10.6%, respectively. The effect on LOS and episode cost was greatest for the Any Diagnosis population, with decreases of 16.0% and 15.8%, respectively. ONS use in hospitalized Medicare patients ≥65 is associated with improved outcomes and decreased healthcare costs, and is therefore relevant to providers seeking an inexpensive, evidence-based approach for meeting Affordable Care Act quality targets.

Keywords: cost; hospital readmissions; length of stay; malnutrition; medicare (search for similar items in EconPapers)
Date: 2014
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DOI: 10.1515/fhep-2014-0011

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