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Forum for Health Economics & Policy

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Can Oral Nutritional Supplements Improve Medicare Patient Outcomes in the Hospital?

Darius N. Lakdawalla
  • Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Julia Thornton Snider / Daniella J. Perlroth / Chris LaVallee / Mark T. Linthicum / Tomas J. Philipson
  • Irving B. Harris School of Public Policy Studies, The University of Chicago, Chicago, Illinois, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jamie S. Partridge / Paul E. Wischmeyer
  • Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA
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  • De Gruyter OnlineGoogle Scholar
Published Online: 2014-10-25 | DOI: https://doi.org/10.1515/fhep-2014-0011


We analyzed the effect of oral nutritional supplement (ONS) use on 30-day readmission rates, length of stay (LOS), and episode costs in hospitalized Medicare patients (≥65), and subsets of patients diagnosed with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia (PNA). Propensity-score matching and instrumental variables were used to analyze ONS and non-ONS episodes from the Premier Research Database (2000–2010). ONS use was associated with reductions in probability of 30-day readmission by 12.0% in AMI and 10.1% in CHF. LOS decreases of 10.9% in AMI, 14.2% in CHF, and 8.5% in PNA were associated with ONS, as were decreases in episode costs in AMI, CHF and PNA of 5.1%, 7.8% and 10.6%, respectively. The effect on LOS and episode cost was greatest for the Any Diagnosis population, with decreases of 16.0% and 15.8%, respectively. ONS use in hospitalized Medicare patients ≥65 is associated with improved outcomes and decreased healthcare costs, and is therefore relevant to providers seeking an inexpensive, evidence-based approach for meeting Affordable Care Act quality targets.

This article offers supplementary material which is provided at the end of the article.

Keywords: cost; hospital readmissions; length of stay; malnutrition; medicare


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About the article

Corresponding author: Julia Thornton Snider, Precision Health Economics, Los Angeles, California, USA, e-mail:

Published Online: 2014-10-25

Published in Print: 2014-09-01

Citation Information: Forum for Health Economics and Policy, Volume 17, Issue 2, Pages 131–151, ISSN (Online) 1558-9544, ISSN (Print) 2194-6191, DOI: https://doi.org/10.1515/fhep-2014-0011.

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