Use assessment and cost analysis of parenteral nutrition for adults in a public hospital

Abstract

The Parenteral Nutrition (PN) is a high-alert medication, with high-cost, indicated for patients in which oral or enteral nutrition is not possible, is insufficient or contraindicated. There are two PN systems currently available, the custom system, prepared in hospital pharmacies or outsourced to specialized clinics, and the standardized compartmentalized bag system. Currently, it is fundamental that the application of financial resources in health be performed efficiently, considering effectiveness, safety and economy. The aim of this study was to evaluate the effectiveness of industrialized NP in the supply of energy and to perform a pharmacoeconomic analysis of cost minimization comparing standardized and custom bags. For this, was determined the total energy expenditure of patient and then determined the adequacy of the prescriptions of PN. For cost analysis was used the values of the standardized bags used for the patient in relation with the hypothetical cost if the same formulation were custom manipulated. 28 patients and 296 PN prescriptions were identified in the study period. The rates of adequacy to the energy expenditure were 39.3% on the 1^st day, 34.6% on the 2nd day, 44.65% on the remaining days of treatment, and 33.33% on the last day. As for the analysis cost, the cost of standardized bags was lower in relation to manipulated bags (p <0.05). It was therefore verified that this was a high level of the inadequacy of the prescriptions of industrialized PN bags and that the same is more cost effective for the hospital in question.