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Dialogue Proceedings / Advancing Patient-Centered Malnutrition Care Transitions

Summary

Although malnutrition can lead to greater risk of chronic disease, frailty, and disability, and increases healthcare costs, patients’ nutrition status is rarely evaluated and managed as they transition across care settings.

Lack of sufficient malnutrition recognition and care across care settings means patients frequently are at risk for and/or develop 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 health care services utilization. For example, in two longitudinal analyseshospitalized malnourished patients had up to a 100% increase 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.

This issue becomes more critical as people age, when their health needs become more complex and impacted by chronic disease, social determinants of health (e.g., access to transportation, housing), and nutrition. 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.

Recognizing these challenges, a multi-stakeholder group of health and community leaders and advocates came together on March 14, 2018, at 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, which outline key considerations and recommendations for clinicians/community and social service providers, patients/caregivers, payers, and policymakers to advance patient-centered malnutrition care transitions.

For more information, please direct any questions to Kelsey Jones or 202-459-6306.

View the full Dialogue Proceedings report and infographic.

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