Impact of Oral Nutrition Supplements on Hospital Outcomes in Pediatric Patients
Impact of Oral Nutrition Supplements on Hospital Outcomes in Pediatric Patients
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DOI：
10.1177/0148607114549769
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发表时间：
2014-11-01
影响因子：
3.4
通讯作者：
Snider, Julia Thornton
中科院分区：
文献类型：
--
作者：
Lakdawalla, Darius N.;Mascarenhas, Maria;Snider, Julia Thornton
背景：营养缺乏在住院儿童中很常见。尽管口服营养补充剂 (ONS) 可能会改善该人群的营养不良，但与其使用相关的益处和医疗费用尚未得到充分探讨。本研究的目的是评估 ONS 使用对住院儿童住院时间 (LOS) 和发作费用的影响。材料和方法：对首要研究数据库中 557,348 名 2-8 岁儿童住院患者进行回顾性分析。在使用和不使用工具变量 (IV) 的分析中估计了 ONS 使用对倾向评分匹配样本中 LOS 和事件成本的影响，以减少未观察到的变量的混杂。结果：557,348 例住院患者中，有 6066 例使用 ONS（1.09%）。在 IV 分析中，使用 11,031 次发作的匹配样本，使用 ONS 住院的 LOS 缩短了 14.8%（6.4 天 vs 7.5 天；1.1 天 [95% CI，0.2-2.4]）。使用 ONS 的住院费用降低了 9.7%（16,552 美元 vs 18,320 美元；1768 美元 [95% CI，1924-1612 美元]）。结论：ONS 的使用与儿科住院患者较低的 LOS 和事件成本相关。 ONS 在住院儿科患者中的使用可能会提供一种经济有效、循证的方法来改善儿科医院护理。
Background: Nutrition deficiency is common among hospitalized children. Although oral nutrition supplements (ONS) may improve malnutrition in this population, the benefits and healthcare costs associated with their use have not yet been fully explored. The objective of this study was to assess the effect of ONS use on inpatient length of stay (LOS) and episode cost in hospitalized children. Materials and Methods: Retrospective analysis of 557,348 hospitalizations of children aged 2-8 years in the Premier Research Database. The effect of ONS use on LOS and episode cost in a propensity score- matched sample was estimated in analyses with and without the use of instrumental variables (IVs) to reduce confounding from unobserved variables. Results: ONS were prescribed in 6066 of 557,348 inpatient episodes (1.09%). In IV analysis, using a matched sample of 11,031 episodes, hospitalizations with ONS use had 14.8% shorter LOS (6.4 vs 7.5 days; 1.1 days [95% CI, 0.2-2.4]). Hospitalizations with ONS use had 9.7% lower cost ($16,552 vs $18,320; $1768 [95% CI, $1924-$1612]). Conclusions: ONS use was associated with lower LOS and episode cost among pediatric inpatients. ONS use in hospitalized pediatric patients may provide a cost-effective, evidence-based approach to improving pediatric hospital care.