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

Meijers, Judith M.M.; Halfens, Ruud J.G.; van Bokhorst-de van der Schueren, Marian A.E.; Dassen, Theo; Schols, Jos M.G.A.

doi:10.1016/j.nut.2008.11.004

« Previous Next »Nutrition
Volume 25, Issue 5 , Pages 512-519, May 2009

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

Judith M.M. Meijers, M.Sc.
- Department of Health Care and Nursing Science, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Corresponding author. Tel.: +31-43-388-1707; fax: +31-43-388-4162
Ruud J.G. Halfens, Ph.D.
- Department of Health Care and Nursing Science, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
Marian A.E. van Bokhorst-de van der Schueren, Ph.D.
- Department of Nutrition and Dietetics, VU University Medical Centre, Amsterdam, The Netherlands
Theo Dassen, Ph.D.
- Department of Nursing Science, Charité Universitätsmedizin, Berlin, Germany
Jos M.G.A. Schols, Ph.D.
- Department of General Practice, Maastricht University, Maastricht, and Tranzo Department, Tilburg University, Tilburg, The Netherlands

Received 2 July 2008; accepted 5 November 2008. published online 12 January 2009.

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.

Keywords: Malnutrition, Nutritional care, Screening, Treatment, Hospitals, Nursing homes, Home care