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ISSN: 1734-1922
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abstract:
Clinical research

Cost-effectiveness of the hospital nutrition screening tool CIPA

José Pablo Suárez-Llanos
,
Laura Vallejo-Torres
,
Miguel Ángel García-Bello
,
Carolina Hernández-Carballo
,
Eduardo Mauricio Calderón-Ledezma
,
Adriá Rosat-Rodrigo
,
Irina Delgado-Brito
,
Francisca Pereyra-García-Castro
,
Nestor Benitez-Brito
,
Nieves Felipe-Pérez
,
Yolanda Ramallo-Fariña
,
Juan Carlos Romero-Pérez

Online publish date: 2019/01/11
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Introduction
Hospital malnutrition is very common and worsens the clinical course of patients while increasing costs. Lacking clinical-economic studies on the implementation of nutrition screening encouraged the evaluation of the CIPA (Control of Food Intake, Protein, Anthropometry) tool.

Material and methods
An open, non-randomized, controlled clinical trial was conducted on patients admitted to internal medicine and general and digestive surgery wards, who were either assigned to a control (standard hospital clinical care) or to an intervention, CIPA-performing ward (412 and 411, respectively; n = 823). Length of stay, mortality, readmission, in-hospital complications, and quality of life were evaluated. Cost-effectiveness was analysed in terms of cost per quality-adjusted life years (QALYs).

Results
The mean length of stay was higher in the CIPA group, though not significantly (+ 0.95 days; p = 0.230). On the surgical ward, more patients from the control group moved to critical care units (p = 0.014); the other clinical variables did not vary. Quality of life at discharge was similar (p = 0.53), although slightly higher in the CIPA group at 3 months (p = 0.089). Patients under CIPA screening had a higher mean cost of € 691.6 and a mean QALY gain over a 3-month period of 0.0042. While the cost per QALY for the internal medicine patients was € 642 282, the results for surgical patients suggest that the screening tool is both less costly and more effective.

Conclusions
The CIPA nutrition screening tool is likely to be cost-effective in surgical but not in internal medicine patients.

keywords:

quality of life, malnutrition, cost-benefit analysis, inpatients, nutrition assessment

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