The quality of nutritional care in hospitals: A comparison between Austria, Switzerland and Turkey

Abstract Objective To investigate the differences in the quality of nutritional care among three countries (Austria, Switzerland Turkey). Methods A cross-sectional multi-center study was conducted. Data were collected using a standardized questionnaire. Descriptive statistics as well as univariate and multivariate logistic regression (adjusted for age, sex, number of diagnoses and care dependency) analyses were performed. Results 6293 patients from 62 hospitals took part in the study. The prevalence of malnutrition risk was 14.5% in Austrian, 16.5% in Swiss and 33.7% in Turkish patients. Standardized screening procedures were applied in 51.3% of Austrian, 53.6% of Swiss and 38.4% of Turkish patients. The interventions applied in risk patients varied significantly between Austrian, Swiss and Turkish hospitals for all but two interventions. Referrals to dietitians were lower in Austria (35.8%) and Switzerland (37.7%) as compared to Turkey (61%). Turkish patients received more frequently ONS, an energy/protein enriched diet, or parenteral nutrition as compared to patients in Austrian or Swiss hospitals. The differences in the quality of nutritional care between Austrian and Swiss hospitals were only marginal. In Austria, 15.3% of risk patients did not receive any intervention, in Switzerland 11.4% and, in Turkey, 5.5% of the patients. Conclusions The findings of this study indicate that significant differences exist in the prevalence, the identification and treatment of malnutrition, as well as the fulfillment of structural quality indicators. Standards and guidelines need to be developed that can be used by all countries. The severity of the situation in hospitals with regard to malnutrition needs further attention in future management policies.