Oral Nutritional Supplements Can Reduce Hospital Stay

I worked as an admitting officer before in a tertiary hospital, I know the amount of money you have to shell out for a certain admission, and the rate differs from each room category, so compute all the amount that you are going to pay for such a simple case of fever. Believe me or not, it will cost you an abruptly Php20k for three days minus the Philhealth and the doctor's professional fees. At the recent event that I have attended,  malnourished patients tend to have more complications, readmissions and longer length of stay.  ″Impaired nutritional status, especially in patients recovering from serious illnesses or surgery, can result in longer hospital stays; an increase in complication rates, higher readmission rates, and associated health care costs, ″ says Dr. Marianna Sioson, president of the Philippine Society for Parenteral and Enteral Nutrition. 

Mindful of new rules and penalties around readmissions and complications, hospital executives are taking a close look at nutrition as a tool to reduce incidence of hospital admissions and costs.

A new health economics outcomes study, conducted by leading health economists and supported by Abbott, found that oral nutritional supplements provided to patients during hospitalization are associated with significant reductions in length of stay and hospitalization cost. Additionally, the 30-day readmission risk was significantly reduced for patients with at least one known subsequent readmission.

Dr. Marianna Sioson

Published in the American Journal of Managed Care, (Feb 2013) the study provides insights into the economic benefits of prescribing oral nutritional supplements to adult patients in the hospital setting.

The retrospective analysis utilized information from more than one million adult inpatient cases found in the 2000-2010 Premier Research Database maintained by the Premier healthcare alliance —representing a total of 44 million hospital episodes from across the United States or approximately 20 percent of all inpatient admissions in the U.S.

Benefits associated with patients provided oral nutrition supplements
during hospitalization included 21% or 2.3 days reduction in length of stay and 21.6% or $4,734, reduction in patient hospitalization cost.

Additionally, there was a 6.7% reduction in the probability of a 30-day readmission in patients who had at least one known subsequent readmission and were provided oral nutrition supplements during the previous hospitalization.

“Research shows that using oral nutritional supplements can help reduce the length of stay and associated hospital costs. This is, indeed, good news for 4 out of 10 hospitalized Filipino patients who are nutritionally at risk since most of them shoulder their hospital expenses out of their own pockets,” according to Dr. Marianna Sioson, president of the Philippine Society for Parenteral and Enteral Nutrition.


″Impaired nutritional status, especially in patients recovering from serious illnesses or surgery, can result in longer hospital stays; an increase in complication rates, higher readmission rates, and associated health care costs, ″ says Dr. Marianna Sioson.

In the study, investigators were able to determine differences in length of stay and costs by comparing hospital stays where oral nutritional supplements were prescribed to stays of similar conditions where oral nutritional supplements weren’t prescribed.

Dr. Rodolfo Dimaano Jr., Medical Director, Abbott 

″In an increasingly cost-pressured environment, health economics assessments can more comprehensively determine a therapy’s true value. Our results point to the tangible benefits of inpatient oral nutritional supplements on health outcomes and cost of care, factors that impact a hospital’s bottom line,” said study co-author, Darius Lakdawalla PhD, Quintiles Chair in Pharmaceutical Development and Regulatory Innovation, USC School of Pharmacy, and Sol Price School of Public Policy, and Director of Research, Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California

″Because oral nutrition supplements are formulated to provide advanced nutrition and calories for compromised patients and are relatively inexpensive to provide, the sizeable savings they generate make supplementation a cost-effective therapy,″ said study co-author, Tomas Philipson PhD, Daniel Levin Chair of Public Policy at the University of Chicago.

About the Study
The ″Impact of Oral Nutritional Supplementation on Hospital Outcomes" study is a retrospective data analysis on the effect of oral nutritional supplements on hospital economic outcomes. The study compared hospital stays where oral nutritional supplements were provided with similar hospital stays that did not provide oral nutritional supplements. The difference between length of hospital stay and cost of treatment (including supplies, labor, depreciation of equipment, etc.) were measured.
The probability of 30-day hospital readmission also was calculated.


About Abbott Nutrition

Abbott is a global healthcare company devoted to improving life through the development of products and technologies that span the breadth of healthcare. With a portfolio of leading, science-based offerings in diagnostics, medical devices, nutritionals, and branded generic pharmaceuticals, Abbott serves people in more than 150 countries and employs approximately 69,000 people.

For more than 85 years, Abbott Nutrition has been developing and marketing science-based nutritional products to support the growth, health and wellness of people of all ages. Internationally recognized brands include the Similac brand of infant formulas; the Gain brand of growing-up milks; the PediaSure brand of complete and balanced nutrition for children; and the Ensure brand of complete and balanced oral nutritional supplements for adults.

The company is a leader in nutritional products clinically shown to address the distinct dietary needs of people with serious health conditions or special nutrient requirements, such as the Glucerna brand of nutrition shakes and bars for people with diabetes.

Take the Glucerna 1-2-3 Challenge for Diabetes Management

The early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes. So have yourself checked up if you are suffering from the following symptoms such as frequent urinating , feeling very thirsty, feeling very hungry - even though you are eating, extreme fatigue, blurry vision, cuts or bruises that are slow to heal. Weight loss- even though you are eating more, tingling, pain, or numbness in the hands or feet.

Dr Sjoberg Kho (Chief of Endocrinology and Metabolism and the unit head of St. Thomas Diabetes Center at University of Sto. Tomas Hospital. He is also an Associate Professor in the UST Faculty of Medicine and Surgery.) explained the symptoms of Diabetes and complications to the media, and introduces Glucerna, a specialized nutrition product from Abbott to manage diabetes.

THE GLUCERNA 1-2-3 CHALLENGE


The Glucerna 1-2-3 Challenge is a 12-week program that was specially designed for people with diabetes to learn simple techniques to help them manage their diabetes with a healthy lifestyle. Sponsored by the makers of Glucerna, a specialized nutrition product from Abbott for people with diabetes, the 1-2-3 Challenge provides resources for people with diabetes to create a simple plan that incorporates 1) a healthy meal plan, 2) exercise, and 3) specialized nutrition products such as Glucerna. The program’s three easy steps help people with diabetes to address three important components of managing their condition – managing blood sugar response, reducing weight and waistline, and supporting heart health.

Dr Sjoberg Kho (Chief of Endocrinology and Metabolism and the unit head of St. Thomas Diabetes Center at University of Sto. Tomas Hospital

How the 1-2-3 Challenge Works– This free 12-week program features a robust set of online tools and solutions provide people with diabeteswith easy, meal plans and recipes, daily exercise planswith step-by-step instructional videos, and guidance on how to incorporate Glucerna into their healthy diet. Additionally, the program provides tracking tools and progress reports so they can monitor their progress that they can share with their doctors.

Why Proper Nutrition Is Important – Eating right and exercising can have an impact on the health of people with diabetes. Additionally, scientific evidence supports the use of calorie replacement, including specialized nutrition, as part of a diabetes management plan.1-2By providing information on exercise and healthy nutrition choices, the 1-2-3 Challenge enables people with diabetes to create healthy habits that will help in :

Managing Blood Sugar Levels –Maintaining proper blood sugar levels is the first step to proper diabetes management and reducing the risk of complications from the condition.

Addressing Weight and Physical Activity – Excess weight and physical inactivity can contribute to health-related complications for people with diabetes.

Supporting Heart Health – Like all individuals, people with diabetes need to maintain heart health. Further, people with diabetes are two to four times more likely to have cardiovascular disease than people without the disease.3

Features of Glucerna Triple Care–The new GlucernaTriple Care™product provides a unique system of ingredients to help patients manage their blood sugar response while supporting heart health. It also can help reduce weight and waistline when used as part of an overall diabetes management plan.

Website and Mobile App – People with diabetes can go to https://www.glucerna123challenge.com.phto participate in the 1-2-3 Challenge.A mobile app also is available for iPhone® or Android® smart phones* for on-the-go access to the program.

Rewards Program – To support the members of the Glucerna 123 challenge, it also has a loyalty program that rewards members with points found in every can of Glucerna Triple Care everytime they purchase.  This rewards program is also extended everytime the members access the website and to update theirlevels of blood sugar, weight and physical activity. This promo activity was submitted and approved by FDA,per DOH-FDA permit no.1386 s.2013

For more information on the Glucerna 1-2-3 Challenge,you may contact[02-995-5555].

About Abbott Nutrition
For more than 85 years, Abbott Nutrition has been developing and marketing science-based nutritional products to support the growth, health and wellness of people of all ages. Internationally recognized brands include the PediaSure® brand of complete and balanced nutrition for children; and the Ensure® brand of complete and balanced nutrition for adults.
                                                           
The company is a leader in nutritional products clinically shown to address the distinct dietary needs of people with serious health conditions or special nutrient requirements, such as the Glucerna® brand of nutrition shakes and bars for people with diabetes.

About Abbott
Abbott is a global healthcare company devoted to improving life through the development of products and technologies that span the breadth of healthcare. With a portfolio of leading, science-based offerings in diagnostics, medical devices, nutritionals and branded generic pharmaceuticals, Abbott serves people in more than 150 countries and employs approximately 70,000 people.

Visit Abbott at www.abbott.com and connect with us on Twitter at @AbbottNews.


DIABETES AND ITS COMPLICATIONS

Diabetes mellitus (DM), or more commonly known as diabetes,refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues.

Diabetes is a worldwide public health problem.2In 2013, the number of diabetic adults reached a total of 380 million and currently, they are estimating that in 2035, the number will rise to over 592 million.

Diabetes in the Philippines

Diabetes in the Philippines is a growing health problem affecting the lives of 9.7% of the adult population in 2012. This number tends to double if we add the 12.5% of Filipinos at-risk of diabetes with impaired glucose tolerance (IGT). Combined, 1 out of every 5 Filipino adults or an estimated 11 million has either prediabetes or diabetes.

Filipinos are considered members of a high-risk ethnic population and this is for the reason that the Filipino diet is accustomed to high levels of sugar content. The data shouldn't come as a surprise for a carbohydrate-loading nation, whose staple meals include rice, bread, sweet potato, corn and other sugary food.

The Department of Health posted diabetes as the 8th top cause of disease-related death in the countryin 2009.6 Cardiovascular diseases are the major cause of death accounting for approximately half of all diabetes fatalities.

According to the World Health Organization, a substantial proportion of newly referred cases of diabetes already have evidence of the micro-vascular complications of diabetes.7 Screening of newly-diagnosed diabetic patients in Manila demonstrated a high prevalence of diabetic complications and cardiovascular risk factors.2 WHO recommends that a screening program to detect diabetes and even pre-diabetes must be instituted.

Complications of Diabetes

Diabetes has often been diagnosed in conjunction with, and worsens other comorbid conditions such as such as coronary artery and peripheral vascular disease, stroke, diabetic neuropathy, amputations, renal failure and blindness and leads to increased disability, reduced life expectancy and enormous health costs worldwide.2

Diabetes does not only affect one’s blood health,it may also affectother body parts:

Cardiovascular Diseases (CVD). Diabetes can cause a heart problem which is the number one cause of death in the Philippines according to the Department of Health-Health Intelligence Service.6People with diabetes have a higher-than-average risk of having a heart attack or stroke. These strike people with diabetes more than twice as often as people without diabetes. There’s a big link between diabetes, heart disease, and stroke. In fact, two out of three people with diabetes die from heart disease or stroke, also called cardiovascular disease.

Eye Complications.This disease is the leading cause of vision loss in adults of working age. 14% of people with diabetes have diabetic macular edema while 25% of people with diabetic macular edema will develop moderate vision loss.

Kidney Disease (Nephropathy).Kidney disease occurs in approximately one third of diabetics. Kidney failure typically occurs after 20-30 years of diabetes and diabetes has become the most frequent condition in people with kidney failure.

Nerve Damage (Neuropathy). Nerve damage from diabetes is called diabetic neuropathy. About half of all people with diabetes have some form of nerve damage. It is more common in those who have had the disease for a number of years and can lead to many kinds of problems.

High Blood Pressure (Hypertension). Caused when your blood moves through your vessels with too much force. Your heart has to work harder when blood pressure is high, and your risk for heart disease and diabetes goes up. High blood pressure raises your risk for heart attack, stroke, eye problems and kidney disease.

Skin Complications. Some of these problems are skin conditions anyone can have, but people with diabetes get it easier. These include bacterial infections, fungal infections, and itching. Other skin problems happen mostly or only to people with diabetes.

Treatment of Diabetes and its Complications in the Philippines

Once complications have been documented, treating hyperglycemia alone will not suffice. Complications from diabetes can be prevented only up to a certain point, beyond which these will progress.

Beyond screening, education of our high risk population regarding diabetic complications must be started also to encourage earlier medical consultation. Medical stakeholders must be encouraged to formulate new guidelines and encourage physicians to be more vigilant in diagnosing and managing diabetic Filipinos.2

If left untreated, diabetes may cause serious complications, as above mentioned.

References
1. Mayo Clinic Staff: Diabetes. (http://www.mayoclinic.org/diseases-conditions/diabetes/basics/definition/con-20033091).
2.  Fojas M, Lantion-Ang F, Jimeno C, Santiago D, Arroyo M, Laurel A, Sy H, See J. Complications and Cardiovascular Risk Factors Among Newly-Diagnosed Type 2 Diabetics in Manila. Phil. J. Internal Medicine 47 (May-June 2009): 99-105.
3.  International Diabetes Federation. (2013).  Diabetes Atlas, http://www.idf.org/diabetesatlas
4.  International Diabetes Federation. IDF Diabetes Atlas, 5th edn. International Diabetes Federation, 2012.
5.  Type 2 Diabetes Practical Targets and Treatments. 3rd ed. 2002: Asia Pacific Type 2 Diabetes Policy Group. 45pp.
6.  Department of Health: Leading Causes of Mortality (http://www.doh.gov.ph/node/198.html).
7.  World Health Organization. Screening for Type 2 Diabetes. (2003).
8.  Heart Disease: American Diabetes Association (http://www.diabetes.org/living-with-diabetes/complications/heart-disease/).
9.  Klein R, Klein BE, Moss SE, Davis MD, DeMets DL: The Wisconsin Epidemiologic Study of Diabetic Retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years.
10.  Kidney Disease (Nephropathy): American Diabetes Association (http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html).
11.  Neuropathy (Nerve Damage): American Diabetes Association (http://www.diabetes.org/living-with-diabetes/complications/neuropathy/)
12.  High Blood Pressure (Hypertension): American Diabetes Association (http://www.diabetes.org/living-with-diabetes/complications/high-blood-pressure-hypertension.html).
13.  Skin Complications: American Diabetes Association (http://www.diabetes.org/living-with-diabetes/complications/skin-complications.html)