Nutritional risk and use of health care services – a missed opportunity? A cohort study on older patients

The primary aim of this study is to investigate associations between nutritional risk and health care use, and the effect of developing of a nutrition plan on use of health care services, morbidity and mortality in older (>65 years) patients. The objectives are to study whether:-being at nutritional risk predicts use of health care services and resources-clinical complications (wounds, infections) mediate the association between nutrition risk and health care service use-a nutrition plan for older patients at nutritional risk predicts use of health care services -a nutrition plan for older patients at nutritional risk is associated with reduced morbidity and mortalityThe following research questions will be investigated, and form the basis for three articles:1.a. Does in-hospital nutritional risk predict health care service use after discharge from hospital?We hypothesize that hospitalized older patients at nutritional risk will, after discharge, use a higher number of services/consultations from community health services, general practitioners, community emergency units, physiotherapists and chiropractors than older patients who are not at nutritional risk.b. Which clinical variables mediate a potential prospective association between nutritional risk and health care service use? We hypothesize that wounds and infections mediate the association. 2.Does development of a nutrition plan for patients at nutritional risk predict their subsequent use of health care services? We hypothesize that patients at nutritional risk with a nutrition plan have a different pattern of health care services use (in both specialist and community health care) compared to patients at nutritional risk without such a plan, and that use of health care services will increase short term and decrease long term for patients who have a nutrition plan. 3.Do patients at nutritional risk with a nutrition plan achieve better outcomes than patients at risk without a nutrition plan? We hypothesize that patients at nutritional risk who have a nutrition plan have lower morbidity and mortality compared to patients at risk who do not have a nutrition plan.