Impact of Oral Nutritional Supplementation at Hospital Discharge on Healthcare Costs in Older Adults: A Retrospective Analysis of Japanese Claims Data.

Overall 360-day healthcare costs were higher in patients prescribed oral nutritional supplements at hospital discharge compared to those not prescribed ONS.

• ONS-at-discharge (ONSd) group costs: 935,092 yen vs. no-ONS-at-discharge (non-ONSd) group costs: 860,588 yen over 360 days postdischarge.
• Adjusted p < 0.001 for this comparison.
• Analysis was based on propensity score matching yielding 26,084 patients (13,042 per group).
• Study used the Kokuho Database (KDB) from Saitama Prefecture, covering April 2017 to March 2022, in patients aged 75 years and older.

Among patients who continued ONS use during the follow-up period, 360-day healthcare costs were lower in the ONSd group than in the non-ONSd group.

• ONSd group costs among continued ONS users: 1,040,830 yen vs. non-ONSd group with follow-up ONS: 1,185,919 yen.
• Adjusted p < 0.001 for this comparison.
• This subgroup analysis specifically isolated patients who were prescribed ONS during the 360-day follow-up period.

Among patients not prescribed ONS during the follow-up period, 360-day healthcare costs remained higher in the ONSd group compared to the non-ONSd group.

• ONSd group costs among non-continued ONS users: 882,465 yen vs. non-ONSd group without follow-up ONS: 847,700 yen.
• Adjusted p < 0.001 for this comparison.
• This suggests that a single prescription of ONS at discharge without continuation did not reduce healthcare costs.

The study enrolled a large retrospective cohort of older adults discharged from hospitals, with a substantial imbalance between those prescribed and not prescribed ONS at discharge.

• Total enrolled patients: 526,605; ONSd group: 13,042; non-ONSd group: 513,563.
• Patients were aged 75 years and older and discharged from hospitals in Saitama Prefecture.
• Data were drawn from the Kokuho Database (KDB) covering April 2017 to March 2022.
• Propensity score matching was used to create balanced comparison groups of 13,042 patients per group.

Malnutrition is described as a common and costly challenge among hospitalized patients and those requiring postdischarge care, and ONS is characterized as a low-cost intervention for undernourished individuals.

• The study frames ONS as a potentially health-economically relevant intervention in the postdischarge setting.
• The study context is older adults (≥75 years) in Japan, a population particularly vulnerable to malnutrition-related complications.
• The Kokuho Database (KDB) was used as the data source, reflecting real-world claims data from Japanese national health insurance.