Cost savings of home parenteral nutrition compared with hospital parenteral nutrition: A multicenter prospective...

Several publications demonstrate the impact of home parenteral nutrition (HPN) in reducing healthcare costs. The question is are HPN practices in Latin America also cost saving when compared with hospital PN? This study aimed to compare the direct healthcare and nonhealthcare costs of HPN with hospital PN through a prospective, analytical, and longitudinal, multicenter noninterventional study.

Adult patients receiving PN were included during the last week of hospital PN (week -1 before discharge), through the first week of HPN (week +1), and up to the first month of HPN (month +1). Clinical, nutrition, and cost variables were recorded. The total direct cost from hospital PN week -1 was compared with HPN week +1. Additionally, HPN month +1 was compared with an estimate of the total costs of hospital PN month -1.

Forty-four patients were included for analysis. Comparing HPN week +1 vs hospital PN week -1. HPN was associated with lower total direct healthcare costs (mean difference -$1498.1, 95% CI -1203.2 to -1789.9). Lastly, the total direct cost (healthcare and nonhealthcare) was lower in the HPN setting vs the hospital setting for 1 week (mean difference $ -1452.0, 95% CI -1756.28 to -1148.4). The cost reduction of HPN for 1 week was 32% (20.3%-42.8%) and for 1 month was 36% (27.5%-48.5%).

HPN is cost saving compared with hospital PN, with most of the cost reduction related to direct healthcare costs.