Comparing prevalence of malnutrition and nutritional care in nursing homes in Germany, Austria and The Netherlands

Introduction: Although malnutrition is a major problem in all health care settings all over the world, there are not much studies carried out in different countries, using the same methodology at a multi-country level about the prevalence, screening and treatment of malnutrition and related quality indicators of nutritional care. Therefore we conducted a study in Germany (G), Austria (A) and the Netherlands (NL). Method: In this cross-sectional international multi-centre study, the prevalence of malnutrition and nutritional care were measured in 3248 patients (G=2444, A=221, NL=583) in 49 nursing homes (G=32, A=4, NL=13). A standardized questionnaire at institutional, ward and patient level was used. Malnutrition prevalence was measured by assessing the nutritional status (BMI, undesired weight loss and nutritional intake). Results: The prevalence of malnutrition in nursing homes in the three countries was comparable (A=28%, NL=27%, G=26%). Nutritional screening at admission occurred more frequently in Germany (94%) than in the Netherlands (88%) and Austria (86%). In the Netherlands in 66% of the malnourished patients a dietician was consulted while in Austria and Germany this occurred only in 29% and 17% respectively. Specific nutritional interventions like energy enriched diet and extra feeding were undertaken in one out of four patients in Austria and the Netherlands, while in Germany this was the case in over 35% of the patients. Conclusion: Malnutrition is a problem in approximately one in every four nursing home patients in each country. Despite the fact that nutritional screening is rather frequently performed, nutritional interventions are provided for less than 50% of the malnourished patients. Note from the Authors: This large-scale international multi-centre study is unique in using a standardized method to compare results between countries. However the results must be interpreted with care, while it is not clear if nursing homes participated are representative for their country. Therefore, in April 2009 this study will be repeated on a lager scale. The results of this measurement will be incorporated in the presentation.