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

Darius N. Lakdawalla 1 , Julia Thornton Snider 2 , Daniella J. Perlroth 3 , Chris LaVallee 4 , Mark T. Linthicum 2 , Tomas J. Philipson 5 , Jamie S. Partridge 6 , and Paul E. Wischmeyer 7
  • 1 Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA
  • 2 Precision Health Economics, Los Angeles, California, USA
  • 3 Center for Primary Care Outcomes Research, Stanford University, Stanford, California, USA
  • 4 Precision Health Economics, Austin, Texas, USA
  • 5 Irving B. Harris School of Public Policy Studies, The University of Chicago, Chicago, Illinois, USA
  • 6 Health Economics and Outcomes Research, Abbott Nutrition, Columbus, Ohio, USA
  • 7 Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA
Darius N. Lakdawalla, Julia Thornton Snider, Daniella J. Perlroth, Chris LaVallee, Mark T. Linthicum, Tomas J. Philipson, Jamie S. Partridge and Paul E. Wischmeyer

Abstract

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.

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