Home parenteral nutrition: a hospital-based program with commercial logistic support

Area of Science:

• Clinical Nutrition
• Healthcare Management

Background:

• Home parenteral nutrition (HPN) programs significantly reduce healthcare costs compared to inpatient care.
• Hospitals traditionally absorb the costs of training and follow-up for HPN programs as non-reimbursable expenses.
• Budget constraints necessitate innovative financial models for sustaining HPN programs.

Purpose of the Study:

• To establish a cost-sharing agreement between a hospital and a commercial home care company for HPN services.
• To offset the financial burden of training and follow-up for HPN programs.
• To maintain quality of care and program efficiency through a collaborative model.

Main Methods:

• A partnership was formed between the hospital's parenteral and enteral nutrition (PEN) team and a commercial home care company.
• The PEN team provides patient instruction and follow-up.
• The home care company provides logistic support and compensates the PEN team based on a fee schedule derived from average patient costs.

Main Results:

• The agreement reduces the need for the commercial company to hire its own nursing and pharmacy staff for HPN patient education and follow-up.
• This model facilitates cost-sharing, making HPN program maintenance more financially sustainable for the hospital.
• It supports regionalized care by leveraging specialized PEN teams in medical centers.

Conclusions:

• Collaborative agreements between hospitals and home care companies can effectively manage the costs associated with HPN programs.
• This model ensures quality control, continuity of care, and efficient patient education for home parenteral nutrition.
• Such partnerships are crucial for the long-term viability of HPN services in resource-constrained environments.