A Survey of Home Enteral Nutrition Practices and Reimbursement in the Asia Pacific Region

• Published in: Nutrients Vol. 10; no. 2; p. 214
• Main Authors: Wong, Alvin, Banks, Merrilyn D, Bauer, Judith D
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.02.2018; MDPI
• Subjects: Asia; Australasia; Clinical nutrition; Costs and Cost Analysis; Developed Countries; Developing Countries; Dietetics - economics; Dietetics - education; Dietetics - manpower; Dietetics - methods; Enteral nutrition; Enteral Nutrition - economics; Enteral Nutrition - methods; Food Handling - economics; Food, Formulated - economics; funding; Health Care Costs; Health Care Surveys; Health Services Accessibility - economics; Health Services Needs and Demand; Home Care Services - economics; Home Care Services - manpower; home enteral nutrition; Humans; Insurance, Health, Reimbursement; Internet; Long-Term Care - economics; Nutrition; nutrition education; Nutrition Policy; nutrition support team; Nutrition therapy; Patient Care Team - economics; Practice Guidelines as Topic; reimbursement; Societies, Scientific; Asia-Pacific region; nutrition education; nutrition support team; funding; reimbursement; home enteral nutrition
• DOI: 10.3390/nu10020214
• ISSN: 2072-6643

Literature regarding the use of home enteral nutrition (HEN) and how it is reimbursed in the Asia Pacific region is limited. This research survey aims to determine the availability of HEN, the type of feeds and enteral access used, national reimbursement policies, the presence of nutrition support teams (NSTs), and clinical nutrition education in this region. An electronic questionnaire was sent to 20 clinical nutrition societies and leaders in the Asia Pacific region in August 2017, where thirteen countries responded. Comparison of HEN reimbursement and practice between countries of different income groups based on the World Bank's data was investigated. Financial support for HEN is only available in 40% of the countries. An association was found between availability of financial support for HEN and health expenditure ( = 0.63, = 0.021). High and middle-upper income countries use mainly commercial supplements for HEN, while lower-middle income countries use mainly blenderized diet. The presence of NSTs is limited, and only present mainly in acute settings. Sixty percent of the countries indicated an urgent need for funding and reimbursement of HEN. This survey demonstrates the varied clinical and economic situation in the Asia Pacific region. There is a lack of reimbursement, clinical support, and inadequate educational opportunities, especially for the lower-middle income countries.