For home health patients who are at risk for malnutrition, a heightened focus on diet and nourishment care can make all the difference when it comes to keeping them out of the hospital — and saving millions of dollars in health care costs.
That’s according to a recent study published in Journal of Parenteral and Enteral Nutrition.
Conducted by researchers from Advocate Health Care and Abbott, the study examined the results of a nutrition‐focused quality improvement program for more than 1,500 home health patients. Among its findings, the study sought to analyze nutrition’s impact on hospitalization rates and health care costs over a 90-day period.
“Health systems are under increased pressure to improve patient care while reducing costs,” Suela Sulo, a health outcomes researcher at Abbott and one of the study’s authors, told Home Health Care News. “Nutrition is one of the most complex challenges in health care, but it can be addressed with simple solutions that can have a dramatic impact on both patient health and healthcare spending. Implementing a nutrition program like this is cost-effective — and the benefits far outweigh the cost of the program.”
Abbott is a Chicago-based health care company that operates in more than 160 countries.
As the largest fully integrated health care delivery system in Illinois, Advocate Health Care has nearly 400 sites of care and 12 hospitals. Advocate Health Care is also part of Advocate Aurora Health, the 10th largest not-for-profit, integrated health system in the U.S.
In the study, researchers note that about 25% of adults receiving home health services were at moderate‐to‐high nutrition risk — making home health agencies an ideal partner for health care organizations in identifying and treating patients with poor nutrition status.
Generally, malnourished patients face a higher risk of complications during hospitalization and are at further risk after discharge.
As part of the quality improvement program highlighted in the study, home health patients were screened for malnutrition, educated on its dangers and provided with a nutrition care plan that included nutritional drinks.
Overall, researchers found that the quality improvement program lowered the risk of hospitalization by 24% in the first 30 days, almost 23% after 60 days and 18% after 90 days.
Additionally, researchers found that prioritizing nutrition care reduced health care costs by more than $2.3 million — roughly $1,500 per patient over the 90 days.
“This study showed a return of investment of nearly $6,” Sulo said. “For each dollar spent, the health system could save approximately $6. Nutrition care is not always top of mind in home health across the U.S., and this new study shows that nutrition programs offer an innovative and cost-effective program that can assist home health agencies looking to advance value-based care.”
The success of a quality improvement program such as the one from the study could lead to more partnerships between home health providers and health care organizations down the road, Katie Riley, vice president and post-acute chief nursing officer for Advocate Aurora Health, told HHCN.
“Home health agencies that promote improved patient outcomes through a nutrition program – using screening tools and nutritional supplementation as part of their care plan – become attractive partners for hospitals, and in particular accountable care organizations (ACOs), as they strive to keep patients from being re-hospitalized,” said Riley, who served as lead author of the study.
Operating alongside home health providers, non-medical home care agencies have long made client nutrition a priority. They include Nebraska-based Home Instead Senior Care, which hires aides skilled in cooking and places them with clients upon request.
One in five people over the age of 75 struggle to cook their own, a 2018 study found.
“Nutrition is important to everyone involved in the care of an older adult at home,” Home Instead gerontologist Lakelyn HoganHogan previously told HHCN. “If an older adult is not getting proper nutrition … that could put them at risk of additional health issues or health concerns.”