Healthcare Resource Utilization and Cost Implications of Commercial Blenderized versus Plant-Based Standard Enteral Formulas in Children and Adults in Post-Acute Care: A Retrospective Study.

PURPOSE: The study investigated the potential association between commercial blenderized tube feeding formulas (CBTF) or plant-based standard tube feeding formulas (STD-TF), and healthcare resource utilization (HCRU) and costs, in children and adults receiving enteral nutrition (EN) in a post-acute care setting.

PATIENTS AND

METHODS

United States insurance claims were retrospectively analyzed to evaluate HCRU and costs for visits to emergency department (ED), inpatient, outpatient, urgent care, and other services at 12 weeks post hospital discharge. Between-cohort comparisons were performed for proportions of patients with claims for each place of service, mean number of visits, and unadjusted and adjusted costs.

RESULTS

Significantly fewer children receiving CBTF vs plant-based STD-TF required inpatient services (16% vs 35%), urgent care (3% vs 10%), ED (15% vs 28%), and other facilities (10% vs 22%) (p < 0.001 for each comparison), with a lower mean number of visits to any healthcare service reported (28 vs 96; p < 0.001). In adults, significantly fewer patients in the CBTF cohort vs the plant-based STD-TF cohort required inpatient (23% vs 38%; p = 0.003) and other services (13% vs 27%; p < 0.001), with a corresponding lower mean number of visits to any healthcare service (24 vs 79; p < 0.001). Total unadjusted costs were significantly lower in both children and adults receiving CBTF compared with plant-based STD-TF (children: $140,962 vs $1,060,345; adults: $166,591 vs $820,905; each p < 0.001). Cost savings associated with CBTF were maintained when costs were adjusted for age, sex, and Charlson's comorbidity index. Children and adults receiving CBTF had significantly lower total adjusted costs compared with those receiving plant-based STD-TF (children: $222,735 vs $965,451; adults: $258,460 vs $919,060 each p ≤ 0.001).

CONCLUSION

The use of CBTF was associated with lower HCRU and costs both in children and adults receiving EN in post-acute care settings. To our knowledge, this is the first large real-world study comparing these formulas in post-acute care across both populations. Although the retrospective design and lack of adjustment for all potential confounders preclude conclusions about causation, these findings may guide formula selection based on potential economic impact.