Nutritional risk and health care use before and after an acute hospitalization among the elderly

Our objective was to assess the nutritional status and health care use of community-dwelling elderly before hospitalization and determine risk factors for longer hospitalizations during 3 mo of follow-up.

During a 1-y period, we recruited patients 65 y and older admitted to an internal medicine ward at Soroka Medical Center (Beer-Sheva, Israel). Data were obtained regarding health and nutritional status and demographic and social characteristics. We assessed the utilization of health care services during a follow-up period of 3 mo.

Seventy-nine of 204 patients (38.7%) were at nutritional risk. Patients at nutritional risk were older (P < 0.001) and less educated (P = 0.03) than the well-nourished group. Nutritional risk was associated with more diagnosed diseases, days of hospital stay, and physician visits before admission. Participants hospitalized for more than 6 d were significantly less educated, with lower cognitive, functional, Mini Nutritional Assessment, and Nutritional Risk Index scores and a significantly higher depressive symptoms score. Functional status and sum of nutritional problems were significant predictors of length of hospitalization in the following 3 mo.

Nutritional risk is a source of concern for health care providers and services, because it significantly increases risk of hospital admission and length of stay. It is important to increase the awareness of primary care providers to the impact of nutrition on health care use and provide appropriate tools to screen and treat nutritional problems.