Systematic review of literature on the cost-effectiveness of nutrition services

• Published in: Journal of the American Dietetic Association Vol. 104; no. 2; pp. 226 - 232
• Main Authors: Pavlovich, Wendy D., Waters, Hugh, Weller, Wendy, Bass, Eric B.
• Format: Book Review Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2004; Elsevier; Elsevier Limited
• Subjects: Ambulatory Care - economics; Benefit cost analysis; Biological and medical sciences; blood glucose; Blood Glucose - metabolism; blood lipids; Cholesterol - blood; Coronary Artery Disease - diet therapy; cost effectiveness; Cost-Benefit Analysis; Diabetes Mellitus - diet therapy; diet therapy; Dietary Services - economics; Dietary Services - standards; health insurance; health services; Human physiology applied to population studies and life conditions. Human ecophysiology; Hypercholesterolemia - diet therapy; Hypertension - diet therapy; Medical sciences; Nutrition; Nutritional survey. Food supply and nutritional requirement; Obesity - diet therapy; Outcome Assessment (Health Care); Outpatient care facilities; Randomized Controlled Trials as Topic - statistics & numerical data; Weight Loss; Human; Review; Educational schedule; Nutrition; Elderly; Cost benefit ratio
• ISSN: 0002-8223; 2212-2672; 1878-3570; 2212-2680
• DOI: 10.1016/j.jada.2003.09.025

Employers and health plan directors would like to know whether it is cost-effective to include outpatient nutrition services as a covered benefit. The purpose of this systematic review was to examine the strength of evidence on the cost-effectiveness of outpatient nutrition services from an economic perspective. All randomized controlled trials published between January 1966 and September 2001 that reported on costs and effectiveness of outpatient nutrition services for any indicated condition were identified and reviewed. Paired reviewers abstracted data from and assessed the quality of each eligible randomized controlled trial; 13 studies met the eligibility criteria. Relatively consistent evidence exists to support the cost-effectiveness of nutrition services in the reduction of serum cholesterol levels (eg, $20 to $1,268 per mmol/L decrease in serum low-density lipoprotein level), weight loss ($2.40 to $10 per pound lost), and blood glucose ($5 per mmol/L decrease), and for target populations with diabetes mellitus and hypercholesterolemia. However, the randomized controlled trials had important limitations and used different cost perspectives. Limited evidence of economic benefit exists to support coverage of outpatient nutrition services for selected indications. More randomized controlled trials of nutrition services should be conducted, taking into consideration all potential candidates for nutrition therapy and all potential costs to patients, providers, and payers.