Survey of Nutritional Screening Status as Well as Dietitian to Patient Ratio in Various Healthcare Setups in India

Abstract

It’s very well documented that malnutrition is an independent risk factor that has an impact on treatment outcomes and further influences the quality of life and survivorship. Nutritional attention with timely intervention is an integral component of patient care which corresponds to improved disease outcomes. Adequate nutrition not only provides economic and physiological benefits but also ensures psychological comfort throughout the patient’s journey and during and after treatment. Evaluation of the patient’s nutritional status is critical in determining the nutritional prescription for the patient. Several studies indicate early identification of malnourished patients or at risk of malnutrition is the key to begin timely and adequate nutrition attention. This multi-centre study attempted a nationwide online survey on malnutrition screening from 19th November to 18th December 2022. Out of 644 responses received, 443 were considered for analysis, and 201 were excluded. Responses from hospitals with less than 50 beds and multiple entries from the same hospital were not considered for analysis. Out of 443 hospitals, 287 (64.7%) were accredited and 156 (35.2%) were non-accredited. It was observed in the survey that nutritional screening (NS) was performed in 361 (81.5%) hospitals out of 443. A majority (90.9%) of the accredited hospitals (n=261) undertook regular NS as opposed to government and charitable trust hospitals (n=100). For NS, 47.4% of accredited and 22.4 % of non-accredited hospitals used a single screening tool of choice. There were 26 non-accredited hospitals with no dietician service. The average number of dieticians in accredited hospitals and non-accredited hospitals were 4.4±3.94 SD and 2.3±3.93 respectively. The dietician-patient ratio in accredited and non-accredited hospitals was 1:73, and 1:212 respectively. Conclusion: Adequate and standard NS practices are lacking in both accredited and non-accredited hospitals with a poor dietitian-to-patient ratio. We propose a better dietician-patient ratio and a simple and rapid first-line tool to detect malnutrition in patients in Indian healthcare setups where there is a massive influx of patients to be matched with multifaceted socio-economic issues and fewer staff. Keywords: Nutrition screening, Malnutrition, Dietitian­Patient ratio, Nutrition care pathway