BACKGROUND AND OBJECTIVES: Protein-energy and micronutrient @entity3147 are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and @entity5275 ( @entity5275 ) nutrition in institutional and home settings. METHODS AND STUDY DESIGN: An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition ( @entity33814 ) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and @entity5275 . RESULTS: The prevalence of @entity3147 was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and @entity5275 were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor @entity5275 use depended on GDP, but was associated with increased use of EN and @entity5275 in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for @entity5275 (p=0.019). CONCLUSIONS: A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.

Health insurance or subsidy has universal advantage for management of hospital XXXX unrelated to GDP.

@entity33814 :: ('27344', 'Gene') :: ['PEN'] @entity3147 :: ('MESH:D044342', 'Disease') :: ['malnutrition'] @entity5275 :: ('MESH:D015819', 'Disease') :: ['parenteral', 'PN']
@entity3147 :: (MESH:D044342,Disease) :: ['malnutrition']
