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Bozeman et al JHEOR 2022 Study Summary

Healthcare Resource Utilization and Cost Comparisons of High-Protein Enteral Nutrition Formulas Used in Critically Ill Patients

 Bozeman MC, Schott LL, Desai AM*, Miranowski MK*, Baumer DL et al.

J Health Econ Outcomes Research 2022;9(1):1-10.

 

Objective:

To compare healthcare resource utilization (HCRU) and hospital costs associated with use of different peptide-based immunonutrition enteral formulas (PBIM) and standard high-protein enteral formulas (StdHP) in adult patients with an ICU stay.

Methods:

Data was retrospectively extracted from the PINC AI™ Healthcare Database from 27 US hospitals between 2015-2019. IMPACT® Peptide 1.5 (IP) was compared with Pivot® 1.5 Cal (PC), and REPLETE® /Promote® (StdHP). A descriptive analysis characterized patients, and multivariable regression followed to assess total hospital cost/day associated with each enteral nutrition cohort.

Results:

• Median volume and days of formula billed were 7 liters over 7 days per median patient stay and ICU stay of 16-days and 10-days, respectively.

• By cohort, select demographic, visit and hospital characteristics are shown in Table 1, and clinical diagnoses and comorbidities in Fig. 1. The IP group had the highest percentage of surgeries.

Figure 1 & Table 1 - Study Summary Bozeman

• Unadjusted cost per day was lowest for the StdHP group (Fig. 2), however, after controlling for multiple variables (i.e., mortality risk, surgery, discharge disposition etc.), average total hospital cost/day associated with IP use was 24% lower than PC and 12% lower than StdHP (p<0.001) (Fig. 3).

Figure 2 & Figure 3

• Translated into approximate dollar values, use of IP in ICU patients was found associated with an estimated adjusted hospital cost/day that was $1,285 dollars lower vs. PC, and $566 lower vs. StdHP (p<0.001) (Fig. 4).

Figure 4. Adjusted cost/ day by EN Formula Group

• 30-day readmissions (unadjusted data) were less frequent for patients receiving IP vs. PC and StdHP; 11.6% vs. 15.3% (p<0.02) and 11.6% vs. 25.6% (p<0.001), respectively

Conclusions:

• Of the PBIM and StdHP formulas studied, IP was associated with the highest cost-savings, having lower adjusted hospital cost per day than PC or StdHP.

• Consider HCRU and daily hospital costs when comparing high-protein formula ingredients and per-unit costs for critically ill patients.

 

Abstract Summary Prepared by Nestlé Health Science.  Download PDF of Summary
The paper is Open Access and may be downloaded at:https://jheor.org/article/36287-healthcare-resource-utilization-and-cost-comparisons-of-high-protein-enteral-nutrition-formulas-used-in-critically-ill-patients 

*Employees of Nestle Health Science

This study was sponsored and funded by Nestle HealthCare Nutrition, Inc.

PINC AI™ is a registered trademark of Premier Inc.
IMPACT® and REPLETE® are a registered trademarks of Société des Produits Nestlé S.A., Vevey, Switzerland.
Pivot® and Promote® are registered trademarks of Abbott Laboratories. Unless as noted, all trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland.

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