Economic burden of hospital malnutrition: A cost-of-illness model

Jesus Fernando B. Inciong*, Adarsh Chaudhary, Han Shui Hsu, Rajeev Joshi, Jeong Meen Seo, Lam Viet Trung, Winai Ungpinitpong, Nurhayat Usman, Lorenzo Pradelli, Abdul Jabbar Omaralsaleh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background & aims: Hospital malnutrition is a highly prevalent condition that leads to an increased risk of clinical complications and a corresponding increase in healthcare resource utilisation. Despite the high prevalence and adverse clinical consequences, limited data are available on the magnitude of the economic burden associated with hospital malnutrition in Asian countries. The aim of the present analysis was to calculate country-specific estimates of the economic burden of hospital malnutrition in Asia. Methods: Country-specific cost and prevalence data were used to calculate the incremental healthcare costs attributable to hospital malnutrition in 11 countries in Asia. The cost-of-illness was evaluated from the public perspective. Sources of increased cost included increased length of stay (LOS) and increased antibiotic use in malnourished patients who develop a healthcare-associated infection. Costs were calculated separately for the ward and intensive care unit (ICU) and currencies were converted to US$ to facilitate comparison. Results: The estimated annual economic burden attributable to hospital malnutrition in Asia is $30.1 billion. Increased LOS accounts for the largest portion of the incremental cost, totalling $23.2 billion (77.2%) in the ward and $3.5 billion (11.5%) in the ICU. Medication costs related to the treatment of infectious complications account for an additional $3.4 billion (11.3%). Countries with the highest incremental costs include Japan ($19 billion), South Korea ($2.5 billion), and Taiwan ($2.2 billion). Conclusions: Hospital malnutrition imposes a substantial economic burden on Asian countries, resulting in an estimated $30 billion per year in additional healthcare costs. This finding underscores the need for rigorous screening and assessment as well as continuous monitoring of nutrition status in hospitalised patients to facilitate early identification and proactive management of hospital malnutrition.

Original languageEnglish
Pages (from-to)342-350
Number of pages9
JournalClinical Nutrition ESPEN
StatePublished - Apr 2022


  • Asia
  • Cost of illness
  • Costs of malnutrition
  • Economic burden
  • Hospital malnutrition


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