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Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data

Background: The population of patients on home parenteral nutrition (HPN) worldwide is growing. Since only a few counties provide data from national registries long-term observations are valuable to address this specific area of nutrition support. This study is a nationwide analysis determining the...

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Autores principales: Folwarski, Marcin, Kłęk, Stanisław, Szlagatys-Sidorkiewicz, Agnieszka, Wyszomirski, Adam, Brzeziński, Michał, Skotnicka, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539115/
https://www.ncbi.nlm.nih.gov/pubmed/34684466
http://dx.doi.org/10.3390/nu13103465
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author Folwarski, Marcin
Kłęk, Stanisław
Szlagatys-Sidorkiewicz, Agnieszka
Wyszomirski, Adam
Brzeziński, Michał
Skotnicka, Magdalena
author_facet Folwarski, Marcin
Kłęk, Stanisław
Szlagatys-Sidorkiewicz, Agnieszka
Wyszomirski, Adam
Brzeziński, Michał
Skotnicka, Magdalena
author_sort Folwarski, Marcin
collection PubMed
description Background: The population of patients on home parenteral nutrition (HPN) worldwide is growing. Since only a few counties provide data from national registries long-term observations are valuable to address this specific area of nutrition support. This study is a nationwide analysis determining the trends in the epidemiology of HPN (prevalence, age distribution, death rates), indications for HPN, causes for hospitalizations, and cost analysis of HPN reimbursement in Poland between 2010–2020. Methods: A retrospective analysis of data obtained from the national health fund (NHF) of Poland on adult patients on HPN. Results: The prevalence of adult patients on HPN in Poland in 2020 was 53.26 per million citizens with a 2.99-fold increase and a growing trend observed from 2010. Significant decrease in the percentage of patients between 18–34, 45–54 and an increase in patients between 65–74 and patients over 75 years old was observed. Trend analysis showed an increase in new patients between 65–74 and a decrease between 35–54. Malnutrition (34.28%), postprocedural disorders of the GI tract (19.61%), intestinal malabsorption/other intestinal diseases (20.41%) and GI obstruction due to cancer (17.36% as primary and 23.16% as secondary diagnosis) were mostly reported as the primary indications for HPN. Cancer patients were mostly gastric, ovarian and colon cancer (34.74%, 17.83% and 12.3%). HPN and total health cost reimbursement increase was 2.6 and 2.57—fold respectively. Costs of HPN and total health care costs in 2020 per patient were € 10,015 and € 16,038, respectively. Overall death risk rate during the first year of nutrition was 0.59 with a significant increase in the observation period p-trend < 0.004. A significant increase in the death rate was observed in patients above 75 years old (estimate 1.629, p-trend < 0.030). Cancer, infection, malnutrition and GI symptoms were the most common indications for hospitalizations of HPN patients. The rate of patients with a maximal length of HPN of 5 months in 2010 was 54.9% and was growing up to 78.1% in 2020. Conclusions: The prevalence of HPN in Poland is growing. Trends of age distribution show increasing numbers of patients with more advanced age and shorter survival. Costs of HPN are comparable with other European data.
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spelling pubmed-85391152021-10-24 Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data Folwarski, Marcin Kłęk, Stanisław Szlagatys-Sidorkiewicz, Agnieszka Wyszomirski, Adam Brzeziński, Michał Skotnicka, Magdalena Nutrients Article Background: The population of patients on home parenteral nutrition (HPN) worldwide is growing. Since only a few counties provide data from national registries long-term observations are valuable to address this specific area of nutrition support. This study is a nationwide analysis determining the trends in the epidemiology of HPN (prevalence, age distribution, death rates), indications for HPN, causes for hospitalizations, and cost analysis of HPN reimbursement in Poland between 2010–2020. Methods: A retrospective analysis of data obtained from the national health fund (NHF) of Poland on adult patients on HPN. Results: The prevalence of adult patients on HPN in Poland in 2020 was 53.26 per million citizens with a 2.99-fold increase and a growing trend observed from 2010. Significant decrease in the percentage of patients between 18–34, 45–54 and an increase in patients between 65–74 and patients over 75 years old was observed. Trend analysis showed an increase in new patients between 65–74 and a decrease between 35–54. Malnutrition (34.28%), postprocedural disorders of the GI tract (19.61%), intestinal malabsorption/other intestinal diseases (20.41%) and GI obstruction due to cancer (17.36% as primary and 23.16% as secondary diagnosis) were mostly reported as the primary indications for HPN. Cancer patients were mostly gastric, ovarian and colon cancer (34.74%, 17.83% and 12.3%). HPN and total health cost reimbursement increase was 2.6 and 2.57—fold respectively. Costs of HPN and total health care costs in 2020 per patient were € 10,015 and € 16,038, respectively. Overall death risk rate during the first year of nutrition was 0.59 with a significant increase in the observation period p-trend < 0.004. A significant increase in the death rate was observed in patients above 75 years old (estimate 1.629, p-trend < 0.030). Cancer, infection, malnutrition and GI symptoms were the most common indications for hospitalizations of HPN patients. The rate of patients with a maximal length of HPN of 5 months in 2010 was 54.9% and was growing up to 78.1% in 2020. Conclusions: The prevalence of HPN in Poland is growing. Trends of age distribution show increasing numbers of patients with more advanced age and shorter survival. Costs of HPN are comparable with other European data. MDPI 2021-09-29 /pmc/articles/PMC8539115/ /pubmed/34684466 http://dx.doi.org/10.3390/nu13103465 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Folwarski, Marcin
Kłęk, Stanisław
Szlagatys-Sidorkiewicz, Agnieszka
Wyszomirski, Adam
Brzeziński, Michał
Skotnicka, Magdalena
Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data
title Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data
title_full Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data
title_fullStr Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data
title_full_unstemmed Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data
title_short Trend Observations in Home Parenteral Nutrition. Prevalence, Hospitalizations and Costs: Results from a Nationwide Analysis of Health Care Provider Data
title_sort trend observations in home parenteral nutrition. prevalence, hospitalizations and costs: results from a nationwide analysis of health care provider data
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539115/
https://www.ncbi.nlm.nih.gov/pubmed/34684466
http://dx.doi.org/10.3390/nu13103465
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