TY - JOUR
T1 - Prevalence of Home Parenteral and Enteral Nutrition in the United States
AU - Mundi, Manpreet S.
AU - Pattinson, Adele
AU - McMahon, Megan T.
AU - Davidson, Jacob
AU - Hurt, Ryan T.
N1 - Publisher Copyright:
© 2017, © 2017 American Society for Parenteral and Enteral Nutrition.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN. Methods: Medicare beneficiary data for 2013 were obtained from Centers for Medicare and Medicaid Services. Commonly used Healthcare Common Procedure Coding System codes were used for home enteral nutrition (HEN) and home parenteral nutrition (HPN). Data regarding number of patients and insurance providers were also obtained from 3 of the largest home infusion providers in the United States (Coram CVS, Option Care Enterprises, and BioScrip Inc). Based on the ratio of Medicare to non-Medicare billing, an estimate of HPEN prevalence was obtained. Results: For 2013, there were 6778 Medicare beneficiaries for HPN and 114,287 for HEN. The ratio of Medicare to non-Medicare was 0.271 for HPN and 0.261 for HEN, leading to an estimated prevalence of 25,011 patients receiving HPN (79 per million U.S. inhabitants) and 437,882 patients receiving HEN (1385 per million U.S. inhabitants). There are an estimated 4129 pediatric patients and 20,883 adult patients receiving HPN; for HEN, 189,036 pediatric patients and 248,846 adult patients. Conclusion: Compared with results from 1992, the prevalence of HEN has increased dramatically, while the prevalence of HPN has declined.
AB - Background: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN. Methods: Medicare beneficiary data for 2013 were obtained from Centers for Medicare and Medicaid Services. Commonly used Healthcare Common Procedure Coding System codes were used for home enteral nutrition (HEN) and home parenteral nutrition (HPN). Data regarding number of patients and insurance providers were also obtained from 3 of the largest home infusion providers in the United States (Coram CVS, Option Care Enterprises, and BioScrip Inc). Based on the ratio of Medicare to non-Medicare billing, an estimate of HPEN prevalence was obtained. Results: For 2013, there were 6778 Medicare beneficiaries for HPN and 114,287 for HEN. The ratio of Medicare to non-Medicare was 0.271 for HPN and 0.261 for HEN, leading to an estimated prevalence of 25,011 patients receiving HPN (79 per million U.S. inhabitants) and 437,882 patients receiving HEN (1385 per million U.S. inhabitants). There are an estimated 4129 pediatric patients and 20,883 adult patients receiving HPN; for HEN, 189,036 pediatric patients and 248,846 adult patients. Conclusion: Compared with results from 1992, the prevalence of HEN has increased dramatically, while the prevalence of HPN has declined.
KW - enteral nutrition
KW - health insurance reimbursement
KW - home care agencies
KW - home care services
KW - home nutritional support
KW - long-term care
KW - parenteral nutrition
KW - reimbursement
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U2 - 10.1177/0884533617718472
DO - 10.1177/0884533617718472
M3 - Article
C2 - 28715295
AN - SCOPUS:85034429966
SN - 0884-5336
VL - 32
SP - 799
EP - 805
JO - Nutrition in Clinical Practice
JF - Nutrition in Clinical Practice
IS - 6
ER -