Abstract
In an effort to improve long-term follow-up and to provide an integrated approach to the care of patients receiving home parenteral nutrition (HPN), a home nutrition support service (HNSS) was formed in 1993 at a large not-for-profit Midwest Health Maintenance Organization (HMO). Because the coordination of care for these patients is managed within the HMO setting, rather than contracting this service out, continuity of care is maintained and provides ease of communication with the physicians and access to patient information. By using a case management approach with the HPN patients, the average cost of HPN per day has decreased by 54% over the past six years. The home nutrition support service in the HMO setting has been cost effective and provides a unique setting for comprehensive patient care.
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