The cost associated with disease-related malnutrition in Ireland

Objective: The present study aimed to establish the annual public expenditure arising from the health and social care of patients with diet-related malnutrition (DRM) in the Republic of Ireland. Design: Costs were calculated by (i) estimating the prevalence of DRM in health-care settings derived from age-standardised comparisons between available Irish data and large-scale UK surveys and (ii) applying relevant costs from official sources to estimates of health-care utilisation by adults with DRM. No attempt has been made to estimate separately the costs of DRM and any associated disease, since each can be a cause or consequence of the other. The methods used are adapted from an evaluation of the cost of malnutrition in the UK by the British Association for Parenteral and Enteral Nutrition (2009). Settings: Hospitals, nursing homes, out-patient clinics, primary-care clinics and home care. Subjects: All adult patients receiving hospital in-patient, out-patient or specified community health-care services. Results: The annual public health and social care cost associated with adult malnourished patients in Ireland is estimated at over (sic)1.4 billion, representing 10% of the health-care budget. Most of this cost arises in acute hospital or residential care settings (i.e. 70%), with nutritional support estimated to account for <3% of spend. Conclusions: The cost associated with the care of patients with DRM is substantial and may rise as the proportion of older people within the population increases, a group at increased risk of DRM. Despite growing pressure on health-care budgets, little attention has been focused on the economic burden associated with DRM in Ireland or the potential for savings arising from improved detection and treatment of those at risk.