Folate testing in hospital inpatients.

Area of Science:

• Clinical Medicine
• Nutritional Science
• Public Health Policy

Background:

• Canada's 1998 folic acid fortification of grain products led to reduced folate deficiency in outpatients.
• Data on folate deficiency prevalence among Canadian hospital inpatients remain limited.

Observation:

• A review of inpatient testing at a major academic institution in 2010 found very low rates of red blood cell folate deficiency (0.16%).
• In contrast, vitamin B12 deficiency and intermediate levels were observed in 3.1% and 13.5% of inpatients, respectively.
• Identified causes of folate deficiency included alcohol abuse, malabsorption, and poor intake due to schizophrenia.

Findings:

• Red blood cell folate deficiency is nearly nonexistent in Canadian hospital inpatients.
• Vitamin B12 deficiency is more prevalent, with a notable percentage of inpatients exhibiting low or intermediate levels.
• The study identified potential annual savings of $32,140 by restricting inpatient red blood cell folate testing.

Implications:

• Routine red blood cell folate testing in Canadian inpatients may not be cost-effective.
• Clinical practice guidelines may need revision regarding inpatient folate level monitoring.
• Healthcare resources could be reallocated to address more prevalent deficiencies, such as vitamin B12.