Impact of nutrition support teams on hospitals' nutritional support in the largest South American city and its metropolitan area

Objective: We evaluated the practice of nutritional therapy (NT) by NT multiprofessional teams (NTMTs) in hospitals of the Sao Paulo metropolitan region to verify its adequacy in meeting the legislation that regulates NT in Brazil. Methods: This was an open prospective study using active research through an inquiry with a multiple-choice, directed, and descriptive questionnaire, which was evaluated using EPI Info 6.04. Data were presented as median and 25th and 75th percentiles and compared according to the considered outcome. P < 0.05 was considered statistically significant. Results: Of 119 evaluated hospitals in the Sao Paulo metropolitan region, 84 were located in the city itself and 35 in the surrounding cities. There were 52 hospitals with NTMTs: 35 in the city of Sao Paulo and 13 in the other cities. No significant statistical differences were found when comparing the hospitals according to size (small, average, large, and specialized) and to the presence of a NTMT. We observed that the philanthropic institutions presented a significantly higher frequency of NTMTs presence. The private, academic, and public hospitals did not present significant differences with regard to the presence of NTMTs. Conclusion: The number of NTMTs in the hospitals of the Sao Paulo metropolitan area is below the requirement established by law; the existence of a NTMT is more frequent in medium and large hospitals; the purchase of the necessary supplies and equipment for the NT practice is more adequate in hospitals with non-public reimbursement; the NTMTs in non-public hospitals were found to be more competent than those in public hospitals in implementing enteral and parenteral nutrition; private hospitals offer better conditions for professional growth for a NTMT staff compared. with public hospitals. (C) 2008 Elsevier Inc. All rights reserved.