Cost-effectiveness analysis of an enteral nutrition protocol for children with common gastrointestinal diseases in China: good start but still a long way to go.
BACKGROUND
A standard nutrition screening and enteral nutrition (EN) protocol was implemented in January 2012 in a tertiary children's center in China. The aims of the present study were to evaluate the cost-effectiveness of a standard EN protocol in hospitalized patients.


METHODS
A retrospective chart review was performed in the gastroenterology inpatient unit. We included all inpatient children requiring EN from January 1, 2010, to December 31, 2013, with common gastrointestinal (GI) diseases. Children from January 1, 2012, to December 31, 2013, served as the standard EN treatment group, and those from January 1, 2010, to December 31, 2011, were the control EN group. Pertinent patient information was collected. We also analyzed the length of hospital stay, cost of care, and in-hospital infection rates.


RESULTS
The standard EN treatment group received more nasojejunal tube feedings. There was a tendency for the standard EN treatment group to receive more elemental and hydrolyzed protein formulas. Implementation of a standard EN protocol significantly reduced the time to initiate EN (32.38 ± 24.50 hours vs 18.76 ± 13.53 hours; P = .011) and the time to reach a targeted calorie goal (7.42 ± 3.98 days vs 5.06 ± 3.55 days; P = .023); length of hospital stay was shortened by 3.2 days after implementation of the standard EN protocol but did not reach statistical significance. However, the shortened length of hospital stay contributed to a significant reduction in the total cost of hospital care (13,164.12 ± 6722.95 Chinese yuan [CNY] vs 9814.96 ± 4592.91 CNY; P < .032).


CONCLUSIONS
Implementation of a standard EN protocol resulted in early initiation of EN, shortened length of stay, and significantly reduced total cost of care in hospitalized children with common GI diseases.
['Yang|Min|M|', 'Chen|Pei-Yu|PY|', 'Gong|Si-Tang|ST|', 'Lyman|Beth|B|', 'Geng|Lan-Lan|LL|', 'Liu|Li-Ying|LY|', 'Liang|Cui-Ping|CP|', 'Xu|Zhao-Hui|ZH|', 'Li|Hui-Wen|HW|', 'Fang|Tie-Fu|TF|', 'Li|Ding-You|DY|']
D000293:Adolescent D002648:Child D002675:Child, Preschool D002681:China D002985:Clinical Protocols D003362:Cost-Benefit Analysis D004750:Enteral Nutrition D005260:Female D005767:Gastrointestinal Diseases D017048:Health Care Costs D006801:Humans D007223:Infant D007902:Length of Stay D008297:Male D044342:Malnutrition D012189:Retrospective Studies D062606:Tertiary Care Centers
cost-effectiveness enteral nutrition children