Cost-effectiveness Study of the New Nutrition Screening Tool CIPA at Hospital Admission

Study Overview
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Brief Summary
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Objectives: To evaluate the cost-effectiveness of implementing a malnutrition screening tool CIPA at the Hospital Universitario Nuestra Señora de la Candelaria (HUNSC), comparing the impact on health and the healthcare costs of hospitalised patients who are screened for malnutrition and of patients following standard clinical practice. Methodology: The study will consist of a controlled trial on patients admitted to the Internal Medicine and General and Digestive Surgery wards at the HUNSC. In both wards patients will be assigned to a control or to an intervention group. The control group will follow usual hospital clinical care, while the intervention group will be administered the screening tool CIPA for early detection of malnutrition cases and they will be treated according to the screening results. The following variables will be evaluated: length of stay in hospital, mortality, readmissions and in-hospital complications. Cost-effectiveness analysis will be undertaken measuring effectiveness by Quality-Adjusted Life Years (QALYs). Cost per patient will be measured by identifying health care resource utilisation, and the cost-effectiveness measure will be the Incremental Cost-Effectiveness Ratio (ICER). Investigators will calculate the incremental cost per QALY gained related to the intervention. This analysis will allow to quantify the costs (incurred and saved) related to the introduction of the malnutrition screening tool CIPA in the hospital context and to measure the health impact of screened patients.

Official Title
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Cost-effectiveness Study of the CIPA Screening Method for Patients With Nutritional Risk at Hospital Admission

Conditions
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Malnutrition

Intervention / Treatment
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* Other: CIPA nutritional screening tool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Formal consent to participate in the study. Patients admitted to the Internal Medicine or General Surgery wards. Exclusion Criteria: Patients treated with nutritional support before CIPA screening is performed. Patients transferred from other wards. Patients with an expected length of stay less than 72 hours. CIPA screening unfeasible for any reason. Patients with poor short-term prognosis. Bed destination at hospital admission nonrandomized. Patients participating in other investigation study. Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CIPA screening tool<br>Patients are evaluated by CIPA nutritional screening tool | Other: CIPA nutritional screening tool<br>* The new nutritional screening tool termed CIPA includes Control of food Intake, Protein, and Anthropometry (CIPA) results positive when at least one of the following parameters is met: control of food intake for 72 h <50%, serum albumin <3 g/dl, body mass index <18.5 kg/m2 or mid-upper arm circumference ≤ 22.5 cm.<br>|
| No Intervention: usual hospital clinical care<br>Patients are not subject of CIPA screening tool, and continue the usual hospital clinical care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cost-effectiveness measured by incremental Cost-effectiveness ratio (ICER) |  | up to 3 months after Hospital discharge time | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of mortality |  | up to 3 months after Hospital discharge time | 
| Quality of life measured by quality-adjusted life years (QALYs) |  | up to 3 months after Hospital discharge time | 
| mean length of stay (days) |  | through study completion, an average of 13 days | 
| incidence of readmissions |  | up to 3 months after hospital discharge time | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nutrition assessment, inpatients, cost-benefit analysis, quality of life, body composition, mass screening