Industry Voices—Nutrition is a 'blind spot' in patient care that needs prioritizing

The nutrition "blind spot" in healthcare comes at a significant cost to patients. (Shutterstock/Artfully photographer)

Despite its recognized importance in all facets of health and healing, nutrition is often overlooked and underserved—and not just within the general population.

There is also a significant gap in how nutrition is addressed in healthcare settings, which creates a critical “blind spot” in patient care.

This nutrition blind spot is not intentional; a lack of focus on the role nutrition plays in health can be seen even in our medical training. Over 70% of U.S. medical schools don’t provide the recommended minimum 25 hours of nutrition education, and 36% provide less than half that much. 

Further, fewer than 14% of physicians believe they have sufficient training to talk to patients about diet or physical activity. Fast-forward years later to when medical students become practicing clinicians, and it is easy to understand why fewer than one-eighth of physician visits include any nutrition counseling and how screening and intervention for poor nutrition might not be top of mind—despite the fact that 1 in 3 adults are malnourished or at risk of malnutrition when admitted to the hospital.

RELATED: Millions of diabetes patients are missing out on Medicare's nutrition help

The nutrition blind spot not only comes at a significant health cost to patients, it also brings a steep financial cost to the healthcare system overall. For example, research from Abbott and the University of Illinois revealed that the U.S. spends upward of $15.5 billion per year in direct medical costs on malnutrition associated with eight diseases: stroke, chronic obstructive pulmonary disease, breast cancer, depression, dementia, coronary heart failure, musculoskeletal disorders and colorectal cancer.

The good news is that when providers screen patients for malnutrition and provide comprehensive nutrition care for those at risk, including education and nutrition supplements when needed, they can efficiently and cost-effectively help drive better patient outcomes.

We see the meaningful impact on both health and financial outcomes when healthcare systems implement nutrition programs. For instance, research by Abbott and Advocate Health Care, the largest health system in Illinois and one of the largest accountable care organizations in the country, demonstrated that when nutrition is prioritized across different healthcare settings, patient health can improve.

Researchers at four Advocate hospitals identified and followed more than 1,200 adults at-risk for malnutrition during hospitalization to assess the impact of a nutrition quality improvement program on length of stay and readmissions. The researchers found that optimizing nutrition care for hospitalized patients at risk for malnutrition was associated with a 29% reduction in 30-day readmission and a 26% or almost 2-day reduction in length of hospital stay.This was associated with an estimated cost savings of more than $4.8 million—or over $3,800 per patient treated—due to shorter hospital stays and lower readmission rates.

RELATED: How Advocate saved $4.8M by improving patient nutrition

But, the role of nutrition in patient recovery is not just limited to hospital settings. Abbott and Advocate implemented similar programs for patients at nutritional risk receiving home healthcare and found that prioritizing nutrition was associated with an 18% reduction in hospitalizations over 90 days, which reduced healthcare costs by more than $2.3 million or about $1,500 per patient treated at risk for malnutrition.

And the benefits of prioritizing nutrition extend to other patient populations, as well.

Scientific evidence shows focusing on nutrition leading up to and following surgery can help decrease complications, shorten length of stay and decrease cost of care. For this reason, healthcare systems are implementing new nutrition guidelines as part of their Enhanced Recovery After Surgery protocols. The guidelines may include immunonutrition, which is designed to support immune health and recovery from surgery, and carbohydrate loading with complex carbohydrate drinks to help reduce insulin resistance after surgery and improve outcomes. Evidence from the Abbott and Advocate study showed that nutrition as part of a comprehensive program reduced 30-day readmissions by nearly 50% and the average length of stay by 2.7 days.

As we continue to study and prioritize nutrition across care delivery settings and patient populations, we can narrow the nutrition blind spot. Healthcare organizations that implement comprehensive nutrition programs have the power to improve patient health and lower their costs of care.

Hakim Bouzamondo, M.D., MSc, MBA, is divisional vice president of nutrition global research and development at Abbott.

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