The costs of disease related malnutrition in hospitalized children

Karen Freijer*, Esther van Puffelen, Koen F. Joosten, Jessie M. Hulst, Marc A. Koopmanschap

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction: Disease related malnutrition (DRM) is a serious medical condition which is associated with an increase in morbidity and mortality, augmenting resource use and associated costs. DRM can be detected by actively and fully assessing the nutritional status. Studies in adult malnourished patients have shown that the additional health care costs are about (sic) 2 billion ((sic) 2000 million) per year. The objective of the current study was to estimate the annual additional costs of DRM for pediatric patients as was done for adults. Methods: A cost-of-illness analysis was performed to calculate the annual additional costs of DRM in 2015 pediatric patients (aged 1 month up to and including 17 years) admitted to non-academic hospitals in The Netherlands. DRM was assessed with weight-for-age, weight-for-height and height-for-age. Input variables in the formula used were length of stay and prevalence of DRM. The costs were estimated per disease as classified in the International Classification of Diseases by the WHO (ICD-10), per gender and age group. The results were expressed as an absolute monetary value as well as a percentage of the Dutch national health expenditure. Robustness of the results was checked by a sensitivity analysis. Results: The total additional direct medical costs of DRM in pediatric patients in 2013 were estimated to be (sic) 51 million for acute malnutrition, (sic) 46 million when focused on chronic malnutrition and (sic) 80 million in case of overall malnourished children. This equals 5.6% of the total Dutch hospital costs for these hospitalized children. Conclusions: This study has shown that DRM in hospitalized children is associated with an increase in annual hospital costs with an additional amount of (sic) 80 million, of which acute malnutrition account for the largest part. (c) 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)228-233
Number of pages6
JournalClinical Nutrition ESPEN
Publication statusPublished - 1 Feb 2018


  • Disease related malnutrition (DRM)
  • Health economic costs
  • Costs of malnutrition children

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