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[Comparative analysis in artificial nutrition]
1Markhot Ferenc Megyei Kórház, Központi Aneszteziológiai és Intenzív Terápiás Osztály, Eger.
Introduction:
It is well known to Hungarian experts in the field of nutrition that hospital inpatients in this country do not have the required nutrition.
Aim:
To compare data of intensive care national costing analysis from England and intensive care unit in County Hospital, Eger, Hungary in order to advise a cost effective nutrition protocol.
Method:
English data were extracted from the report of Intensive Care National Cost Block Programme, year 1999. The Hungarian data were obtained by top down method from annual costing report of the same year. The authors used Purchasing Power Parity to make international cost comparison between these countries.
Results:
In proportion to Purchasing Power Parity, the hospital budget per patient for nutrition is more than double in England than in the studied intensive care unit in Hungary. Intensive care units in England spend 1% on nutrition, 13% on drugs and 10% on disposables. There is only 0.2% spent on nutrition, 29.8% on drugs and 8% on disposables in the studied intensive care unit in Hungary. Cost of nutrition per patient day is HUF 117 in Hungary, which is even lower than the hospital budget per patient day for nutrition.
Conclusion:
On the basis of the above findings and literature review as well, the authors set up a cost effective nutrition guideline: 1. Identify malnourished patient. 2. Nutrition can be delayed for 4-5 days in not malnourished patient. 3. Enteral nutrition should always be the first choice. 4. Total parenteral nutrition is beneficial only if given over at least 7 days. 5) It is cost effective to prevent nosocomial infections even at higher cost.