People with short bowel syndrome (SBS) need a high-touch approach to be effectively managed. Option Care Enterprises, Inc. has a nutritional support team providing clinical interventions, and it recently released a study showing that this approach can save millions of dollars in costs per year, AIS Health reported.
People with SBS have a hard time absorbing nutrients and maintaining hydration and electrolyte balance, and diarrhea is common. Dehydration is a common, even fatal, aspect of this condition, and it often results in hospitalization with an average three-day length of stay.
Patients who are released from the hospital and receiving home parenteral support often are readmitted due to dehydration. Option Care has nutrition support teams that include a registered dietitian, nurse and pharmacist to manage these patients, including assessing whether they are getting the appropriate home parenteral nutrition volume.
Researchers evaluated 116 people with a diagnosis of SBS who were at least 18 years old and started on home parenteral nutrition between June 1, 2017, and June 1, 2018.
Of the 116 patients, 14 were readmitted to the hospital within two weeks of being discharged, but none of those readmissions was due to dehydration. Sixty-three interventions — all of them increases in parenteral nutrition volume — were made during the four weeks following discharge.
Researchers assumed an average three-day hospitalization for each of those 63 adjustments, resulting in an estimated 189 hospital days saved in the first month after discharge. With each hospital day costing $2,000, this translates into $378,000 in health care dollars saved in the first month. Projected annual hospital days saved were 2,268, and projected annual health care dollars saved were more than $4.5 million.
According to Mary Englert, area lead, nutrition support dietitian at Option Care and co-author of the study, “it is important to constantly assess each patient’s estimated fluid needs, especially in the early post-surgical phase of their treatment.”
Beyond the financial savings from avoiding a readmission, patients are not at risk of acquiring a hospital-acquired infection, which itself also can be costly. Their quality of life is better as well, says Englert.
This study, she tells AIS Health, demonstrates that “proactive interventions by nutrition support clinicians resulted in a reduction in unplanned hospital admissions for dehydration, therefore reducing costs that would have otherwise been incurred by less careful monitoring.”