Home enteral nutrition is a convenient and effective way to support the nutritional needs of patients who do not require continuous hospitalization. At Hoist Medical, we offer a range of enteral feeding devices, such as tubes, gastrostomy buttons, enteral syringes, accessories and drainage bags, to improve patients' quality of life. In this article, we will explore the reasons for using artificial feeding at home and its benefits.
What is home enteral feeding?
Home enteral nutrition is an effective way to provide adequate nutrition to patients who are unable to consume food by mouth due to medical conditions such as swallowing disorders, gastrointestinal diseases or neurological disorders. This management can improve patients' quality of life by allowing them to remain at home and avoid prolonged hospital stays. Enteral nutrition devices play a crucial role in the success of this treatment method.
Enteral nutrition tubes are used to deliver fluids containing nutrients directly into the stomach, duodenum or jejunum. Gastrostomy tubes are silicone or polyurethane tubes surgically inserted into the stomach to allow for the administration of nutrients. Enteral syringes are used to administer small volumes of enteral nutritional supplies. And drainage bags collect gastric and intestinal fluids.
These devices can be prescribed to patients, allowing them to receive personalized care and enteral nutrition in their homes. This can also reduce treatment costs for patients and healthcare providers.
On April 30, 2013, an experiment on more than 3 million days performed for 9,427 patients cared for at home or in retirement institutions was published by the home enteral nutrition unit (NEAD) of the Forcilles medical center (Seine-et-Marne). Let's see what this study tells us.
Which population uses home care the most?
Among the NEAD patients, we find:
- 61.6% male;
- 38.4% female;
- the average age, calculated at the date of the beginning of the first care, is 63 years.
Regarding the majority of pathologies, oncological diseases remain slightly preponderant (48.8%), followed by neurological diseases (39.5%). Among the cancer-related diseases, we find :
- cancers of the upper aerodigestive tract for 75.1%;
- Other cancer locations (stomach, colon, etc.) represent 24.9%.
Among the conditions of neurological origin, we find:
- degenerative neurological diseases (Alzheimer's disease, senile dementia, Parkinson's disease, multiple sclerosis, etc.) for 64.3%;
- Stroke for 30.8%;
- Sequelae of traumatic brain injury (TBI) for 4.9% of patients in the group.
In contrast to cancer, this group of conditions is clearly female-dominated (60.6%).
Finally, mental anorexia, metabolic diseases (glycogen, mitochondrial disease...), represent 11.7% of patients with an almost perfect parity between men and women.
What are the benefits of home enteral nutrition?
According to a study published in the journal Nutrition in Clinical Practice, home enteral nutrition can improve the daily lives of patients with advanced cancer by reducing symptoms such as pain, fatigue and nausea. The study also found that NEAD contributed to their survival.
Overall, home enteral feeding programs followed by nutrition support teams have significantly reduced hospital admissions, length of hospital stay and intensive care. According to another survey published in the Journal of Parenteral and Enteral Nutrition, specialized NEAD is associated with a significant decrease in :
- prevalence of pneumonia (24.1% vs. 14.2%);
- respiratory failure (7.3% versus 1.9%);
- urinary tract infection (11.3% vs. 4.9%);
- anemia (3.9% versus 0%).
Such management with support teams reduces morbidity and costs associated with long-term enteral feeding.
What are the developments in the management of NEAD?
This type of service results in substantial savings for our health care system while allowing these patients to return to their homes to optimize their physical and psychological comfort.
Between 2000 and 2013, there were no changes in the NEAD management packages with or without pumps, nor in the rates for the rental of serum stands or for probes and buttons. The changes between these two periods only include the addition of a single "installation" fee of €178 for the first 14 days of care and an increase in the reimbursement of the various types of nutrients, depending on their composition.
The total calculated cost of a day of enteral nutrition for a follow-up unit is 20.17 €. The average duration of care is 324.51 days, so the total cost of care can be estimated at 6,545 €.
The need for a rigorous medical and dietary follow-up of patients is always imperative if we want a nutritional service that is irreproachable in terms of quality and safety.
In conclusion, home enteral nutrition is an effective method of providing adequate nutrition to patients. Enteral nutrition devices play a crucial role in the treatment of various medical conditions. The benefits of NEAD include improved quality of life, reduced feeding complications, and reduced treatment costs for patients and providers.
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