Malnutrition in Dutch health care: Prevalence, prevention, treatment, and quality indicators

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 25; no. 5; pp. 512 - 519
• Main Authors: Meijers, Judith M.M., M.Sc, Halfens, Ruud J.G., Ph.D, van Bokhorst-de van der Schueren, Marian A.E., Ph.D, Dassen, Theo, Ph.D, Schols, Jos M.G.A., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2009; [New York]: Elsevier Science Inc; Elsevier; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Awareness; Biological and medical sciences; Body Mass Index; caregivers; Cross-Sectional Studies; diet-related diseases; Dietary Guidelines; disease prevalence; disease prevention; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Health care; Health care industry; health services; Health Status Indicators; Home care; Home Care Services - standards; Hospitals; Hospitals - standards; Humans; kwashiorkor; Male; Malnutrition; Malnutrition - diagnosis; Malnutrition - epidemiology; Malnutrition - therapy; Netherlands - epidemiology; Nursing homes; Nursing Homes - standards; Nutrition; Nutrition Assessment; nutrition education; nutritional adequacy; Nutritional care; nutritional intervention; Nutritional Status; Nutritive value; patient care; patient education; patients; Prevalence; Quality of Health Care; Screening; Surveys and Questionnaires; Treatment; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Netherlands; Screening; Nursing homes; Home care; Treatment; Hospitals; Nutritional care; Malnutrition; Prevalence; Nutrition; Health; Nutrition disorder; Medical screening; Epidemiology; Care; Prevention; Vertebrata; Mammalia; Quality; Hospital; Dutch
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2008.11.004

Abstract Objective In most health care organizations there is still insufficient awareness for recognizing and treating malnourished patients. To gain more insight into nutritional care policies in Dutch health care organizations, this study investigated screening, treatment, and other quality indicators of nutritional care. Methods In 2007 a cross-sectional multicenter study was performed that included 20 255 patients (hospitals, n = 6021; nursing homes, n = 11 902; home care, n = 2332). A standardized questionnaire was used to study nutritional screening and treatment at the patient level and quality indicators at institutional and ward levels (e.g., malnutrition guidelines/protocols, nutritional education, and weighing policy). Results Nutritional screening was performed more often in nursing homes (60.2%) than in hospitals (40.3%) and home care (13.9%, P < 0.001). In general, one in every five patients was malnourished, and nutritional treatment was applied in fewer than 50% of all malnourished patients in nursing homes, hospitals, and home care. At ward level nursing homes focused more on the quality of nutritional care than did hospitals and home care, especially with respect to controlling the use of nutritional guidelines (54.6%, P < 0.03), weighing at admission (82.9%, P < 0.01), and mealtime ambiance (91.8%, P < 0.01). Conclusion This large-scale study shows that malnutrition is still a considerable problem in one of every five patients in all participating health care settings. It furthermore demonstrates that recognizing and treating malnutrition continues to be problematic. To target the problem of malnutrition adequately, more awareness is needed of the importance of nutritional screening, appropriate treatment, and other nutritional quality indicators.