Comparing quality of nutritional care in Dutch and German nursing homes

Aims and objectives. This study investigates possible differences in malnutrition prevalence rates in Dutch and German nursing homes. It seeks to provide insight into the screening, prevention and treatment of malnutrition and the indicators for nutritional care policy. Background. For decades, malnutrition has been an important problem in health care settings worldwide. A considerable percentage of frail older people suffer from malnutrition. In European nursing homes, the reported prevalence rates range widely (2% to 85%). Method. This is a multicentre, cross-sectional prevalence study of malnutrition in Dutch and German nursing homes using standardised methodology, with the participation of respectively 5848 and 4923 residents (65+ years). Results. Patient characteristics differed significantly between the two countries. Dutch residents were more often male, younger, more care-dependent and significantly more at risk of malnutrition (31.7%). However, overall malnutrition prevalence rates did not differ significantly (Netherlands 26.8% and Germany 26.5%). All German residents were screened at admission, whereas only 73.1% of the Dutch residents were. As part of screening, nutritional screening tools were used in 38.0% of Dutch and 42.1% of the German residents. A dietician was consulted for 36.7% Dutch and 9.3% German malnourished residents. The proportion of malnourished receiving nutritional intervention was larger in Germany than in the Netherlands. Structural indicators for nutritional policy were fulfilled more often in the Netherlands care at institutional level whereas in Germany they were fulfilled more often at ward level. Conclusion. In this study, German residents had a somewhat better nutritional status than Dutch residents and more is done to enhance nutritional status in German nursing homes. The differences would be somewhat larger if both populations were more comparable. Relevance to clinical practice. Comparing malnutrition prevalence rates, prevention and interventions in health care institutions and countries gives insight into international differences in quality of care.