High costs and limited dietitian services for home enteral nutrition users: A Canadian study

Home enteral nutrition (HEN) is the provision of nutrition through a tube outside the hospital. The Canadian prevalence of HEN is not previously well understood. This study aimed to (1) describe the demographics and healthcare usage of HEN in adults in a Canadian health authority, (2) compare the proportion of HEN-related hospital visits between patients who did and did not receive a community registered dietitian (RD) follow-up, and (3) determine associations between demographic and healthcare usage of HEN adults .

A retrospective chart review was conducted on the records of HEN patients with a tube placed between April 1, 2012, and March 31, 2015. Descriptive and comparative statistics were applied.

A total of 390 adults were discharged receiving HEN. The majority (74.9%, n = 271) of the sample did not have any record of visiting a community RD up to 6 years after tube placement. Fifty-three percent of the sample visited the hospital for HEN-related complications, costing CAD $14,324,465.00 (USD $10,677,946.00) to the healthcare system. Multiple regression analysis revealed that females ( P < .05), jejunostomy tubes ( P < .05), and older age ( P < .05) were associated with more hospital or emergency room visits.

This study found a higher prevalence of HEN patients and more varied demographic and clinical characteristics than previously reported. The healthcare costs per patient per year exceed previous reports. Further research is needed to explore the population's experiences and develop interventions that improve gaps in the healthcare system.