Stanislaw Klek1, Michael Chourdakis2, Stephan Bischoff3, Sergiej Dubrov4, Alastair Forbes5, Aleksander Galas6, Laurence Genton7, Haldun R Gundogdu8, Oivind Irtun9, Ilze Jagmane10, Triin Jakobson-Forbes11, Adam Jirka12, Nicholas Kennedy13, Andrius Klimasauskas14, Igor Khoroshilov15, Miguel Leon-Sanz16, Maurizio Muscaritoli17, Marina Panisic-Sekeljic18, Kalliopi Anna Poulia19, Stephane Schneider20, Ulla Siljamäki-Ojansuu21, Mehmet Uyar22, Geert Wanten23, Zeljko Krznaric24. 1. Stanley Dudrick's Memorial Hospital, General Surgery Unit, Skawina, Poland. Electronic address: klek@poczta.onet.pl. 2. School of Medicine, Aristotle University of Thessaloniki, Greece. 3. Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany. 4. National O. Bohomolets Medical University, Department of Anesthesiology and Intensive Care, Kyiv, Ukraine. 5. Norwich Medical School, University of East Anglia, Norwich, UK. 6. Jagiellonian University Medical College, Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Krakow, Poland. 7. Clinical Nutrition, University Hospital, Geneva, Switzerland. 8. General Surgery and Gastrointestinal Surgery Atatürk Teaching and Research Hospital, Ankara, Turkey. 9. Gastrosurgery Research Group, UiT The Arctic University of Norway and Division of Surgery, Oncology and Women's Health, University Hospital of North Norway, Norway. 10. The Riga East Clinical University Hospital, Riga, Latvia. 11. Tartu University Hospital, Anaesthesiology and Intensive Care Clinic, Tartu, Estonia. 12. Kralovske Vinohrady University Hospital, Internal Medicine Department, Prague, Czech Republic. 13. Trinity College Dublin, Dublin, Ireland. 14. Vilnius University, Medical Faculty, Clinic of Anaesthesiology and Reanimatology, Vilnius, Lithuania. 15. North-Western State Medical University named after I.I.Mechnikoff, Saint-Petersburg, Russian Federation. 16. Servicio de Endocrinologia y Nutrition, Hospital Universitatrio 12 de Octubre, Madrid, Spain. 17. Department of Clinical Medicine, Sapienza, University of Rome, Italy. 18. Medical Academy University Clinic for General Surgery Department for Perioperative Nutrition, Belgrade, Serbia. 19. Laiko General Hospital, Athens, Greece. 20. Gastroenterology and Nutrition, Archet University Hospital, Nice, France. 21. Tampere University Hospital, Nutrition Unit, Tampere, Finland. 22. Ege University Hospital, Department of Anesthesiology and Intensive Care, Izmir, Turkey. 23. Radboud University Medical Center, Nijmegen, The Netherlands. 24. School of Medicine, University of Zagreb, Croatia.
Abstract
BACKGROUND AND AIM: Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state's economy on the implementation of EN and PN to define its role in ONCA. MATERIAL AND METHODS: an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n = 20). RESULTS: EN and PN were used in all countries surveyed (100%), but to different extent. The country's income significantly influenced the reimbursement for EN and PN (p < 0.05). It was also associated with the overall use of tube feeding and PN (p = 0.05), but not with the use of oral nutritional supplements (p = 0.165). The use of both, EN and PN at hospitals was not depended on the economy (p > 0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p = 0.042). CONCLUSIONS: Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.
BACKGROUND AND AIM: Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state's economy on the implementation of EN and PN to define its role in ONCA. MATERIAL AND METHODS: an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n = 20). RESULTS: EN and PN were used in all countries surveyed (100%), but to different extent. The country's income significantly influenced the reimbursement for EN and PN (p < 0.05). It was also associated with the overall use of tube feeding and PN (p = 0.05), but not with the use of oral nutritional supplements (p = 0.165). The use of both, EN and PN at hospitals was not depended on the economy (p > 0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p = 0.042). CONCLUSIONS: Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.