Good nutrition is a human right, and nutritional care is essential in many disease treatments. In the future, effectiveness and evidence-based methods will increasingly guide healthcare systems' decision-making. It is important to evaluate and shed light on the effectiveness and cost-effectiveness of nutritional care.
Cost-effectiveness is commonly evaluated by counting the care expenses and the benefits as life years, clinical variables, or substitute variables. Clinical variables can be, for example, avoided health incidents, whereas substitute variables can be changes in laboratory results. Cost-utility analysis utilizes the Quality Adjusted Life Years (QALYs) and incremental cost-effectiveness relations (ICER) that describe the efficiency ratio of the additional benefits, for example, QALYs, acquired from the treatment compared to alternative care.
In Finland, around 18% of deaths are related to nutritional risk factors, according to the OECD. Malnutrition causes remarkable hospital costs by increased hospital stays, infections, and complications. Nutricia and a Finnish company Ravistamo Oy estimated that Finland could save over 500 million euros by treating malnutrition of the aging population. However, the evidence on the effectiveness of oral nutrition supplementation on malnutrition among sick elderly is weak. Most cost-effectiveness studies are methodologically weak, and further research is needed.
The importance of nutritional therapy
Improving nutrition can prevent and alleviate diseases, such as obesity, type 2 diabetes, and cardiovascular diseases. According to a systematic review, dietitian-led nutritional counseling is effective in weight loss among type 2 diabetes patients, and costs are lower than in counseling provided by other professionals. Nutritional therapy also decreases hospital visits among type 2 diabetes patients and positively affects blood lipid values and life years among dyslipidemic patients, leading to cost savings.
There is research on the cost-effectiveness of nutritional therapy in intestinal disorders. The only treatment for celiac disease is a lifetime gluten-free diet. Among children with celiac disease, follow-up meetings with dietitians have been as effective as meetings with medical doctors, leading to reduced costs. However, nutritional therapy is not associated with diet compliance, intensity of symptoms, or quality of life among adult celiac disease patients. As a treatment for irritable bowel syndrome, nutritional therapy has significantly reduced the symptoms and is probably cost-effective.
Did you know?
- In the Research Center for Human Functioning there are two ongoing major studies that focus on nutrition of the working-aged: Mind Nutrition and RAVI. This article was written as a part of the Mind Nutrition study.
- The Mind Nutrition -study studies the effectiveness of improving nutrition on depressive symptoms and related sick leave and work ability. It is also working to identify associations and interactions between nutrition, mental health and work ability in the Finnish working-aged population.
- The Mind Nutrition study is a randomised controlled intervention trial (RCT) investigating the effects of nutrition therapy on depressive symptoms and work ability.