Abstract ID = 77 | Classification: (2) - Malnutrition and related issues

Title: Association between malnutrition and health care cost among community-dwelling older Chinese adults

Author(s): Yuhui Zhang, PhD; Linlin Fan, MA; Shirley Li, MD; Jamie Partridge, PhD; Ling Claytor, MD, PhD; Scott Goates, PhD

Institution where study was conducted: China Health Economics Association, Beijing, China;Abbott Laboratories, Illinois, USA; University of Illinois Urbana-Champaign, Illinois, USA

Keywords: Nutrition, Malnutrition, China, Elderly, Economics, Cost

Background: China has a large and growing elderly population. However, research on the association between malnutrition and healthcare costs in the community setting in China is limited.

Objectives: This paper aims to study the association between malnutrition and hospital costs among community-dwelling older Chinese adults.

Methods: A sample of 7,768 adults aged 60 years or older from the 2013 China Health and Retirement Longitudinal Study were included in the analysis. Handgrip strength, body mass index and weight loss were used as indicators of malnutrition status. Negative binomial regressions were employed to analyze the associations between malnutrition and the number of hospital admissions and outpatient visits. A two-part model was used to analyze the impact of malnutrition on hospital cost. The first part studied the impact of malnutrition on the use of inpatient and outpatient services, and the second part investigated the impact of malnutrition on inpatient and outpatient cost, conditional on using medical services. Analysis controlled for socio-demographics, health status, health insurance, and quality of healthcare.

Results: Malnutrition was associated with 32% more hospital admissions and 31% higher inpatient cost per year; 17% more outpatient visits, and 9% more outpatient cost per month (all p<0.01). In total, malnutrition was associated with ¥32.37 ($4.62) billion and ¥13.47 ($1.92) billion additional inpatient and outpatient costs every year (all p<0.01) in China.

Conclusion: Malnutrition was associated with significantly more hospital admissions, higher hospital outpatient visits and associated costs. These results suggest that malnutrition is an independent predictor of hospital cost and healthcare resource utilization, thus highlighting the importance of malnutrition screening, identification, and treatment for older Chinese adults living in the community.

Email: scott.goates@abbott.com

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