Modelling the burden of disease associated malnutrition

Background & aims: Disease associated malnutrition (DAM) is a frequent but often unrecognised problem associated with increased morbidity and utilisation of health care, decreased quality of life and premature mortality. The aim was to estimate the financial and health burden of DAM in Europe. Methods: A model was developed to estimate direct incremental health care costs and health loss (including increased mortality and reduced quality of life expressed in lost quality adjusted life years [QALYs]). Ten primary diseases were incorporated into the model: stroke, coronary heart disease, breast cancer, colorectal cancer, head and neck cancer, chronic obstructive pulmonary disease, dementia, depression, musculoskeletal disorders and chronic pancreatitis. Results: In Europe in 2009, the direct financial burden of DAM in ten primary diseases was over 31 billion EUR and DAM was responsible for 5.7 million lost life years and 9.1 million QALYs. The total monetary value of health and financial burden of DAM exceeds 305 billion EUR annually. Conclusions: In Europe, DAM only in ten primary disease areas represents a significant contribution to the total burden of disease estimated by the WHO to be 255 million DALYs annually. Policy makers should support programmes to extend the clinical and economic evidence base of nutritional care, with the ultimate aim of reducing the resource burden associated with malnutrition.

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