Home Enteral Nutrition in Singapore's Long-Term Care Homes-Incidence, Prevalence, Cost, and Staffing

• Published in: Nutrients Vol. 11; no. 10; p. 2492
• Main Authors: Wong, Alvin, Sowa, P Marcin, Banks, Merrilyn D, Bauer, Judith D
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 17.10.2019; MDPI
• Subjects: Calories; Cognitive ability; cost; Cross-Sectional Studies; Dementia; Dietitians; Dysphagia; Endoscopy; Enteral feeding; Enteral nutrition; Enteral Nutrition - economics; Enteral Nutrition - statistics & numerical data; Feeding; Female; Gastrostomy; Gravitation; Gravity; Health Care Costs; Health Personnel - economics; home enteral nutrition; Hospitals; Humans; Impairment; Incidence; Intubation, Gastrointestinal; Long term health care; Long-Term Care; Male; Manpower; Medical personnel; Nasogastric feeding; Nurses; Nursing homes; Nursing Homes - statistics & numerical data; Nutrition; Nutrition assessment; Nutrition research; Ostomy; Outsourcing; Parenteral nutrition; Patients; Polls & surveys; Population; Private sector; Purchase orders; Questionnaires; Singapore; Speech; Subsidies; Swallowing; Texture; tube feeding; Workforce planning; Singapore; Australia; United States > US; Asia; Europe; Germany; dysphagia; tube feeding; cost; home enteral nutrition; long-term care
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11102492

: Data on home enteral nutrition (HEN) in long-term care facilities (LTCF) in Singapore is scarce. This study aims to determine the prevalence and incidence of chewing/swallowing impairment and HEN, and the manpower and costs related. A validated cross-sectional survey was sent to all 69 LTCFs in Singapore in May 2019. Local costs (S$) for manpower and feeds were used to tabulate the cost of HEN. Nine LTCFs (13.0%) responded, with a combined 1879 beds and 240 residents on HEN. An incidence rate (IR) of 15.7 per 1000 people-years (PY) and a point prevalence (PP) of 136.6 per 1000 residents were determined for HEN, and an IR of 433.0 per 1000 PY, with PP of 385.6 per 1000 residents for chewing/swallowing impairment. Only 2.5% of residents had a percutaneous endoscopic gastrostomy (PEG). The mean length of residence in LTCF was 45.9 ± 12.3 months. More than half of the residents received nasogastric tube feeding (NGT) for ≥36 months. Median monthly HEN cost per resident was S$799.47 (interquartile range (IQR): 692.11, 940.30). Nursing costs for feeding contributed to 63% of total HEN costs. The high usage and length of time on NGT feeding warrants exploration and education of PEG usage. A national HEN database may improve the care of LTCF residents.