J Korean Dysphagia Soc.  2023 Jan;13(1):34-47. 10.34160/jkds.2023.13.1.005.

Meal Service and Nutritional Management for Dysphagia: A Nationwide Hospital Survey

• Lee JS
• Lim HS
• Kim A
• Kim TL
• Shin WS
• Ju DL
• Oh BM

• KMID: 2539464
• DOI: http://doi.org/10.34160/jkds.2023.13.1.005

Abstract

Objective
This study enrolls diverse hospitals and analyzes the differences in meal provision and nutrition management services for patients with dysphagia.
Methods
A nationwide survey was conducted by mail and mobile for 850 medical institutions, and data were collected from 217 hospitals. We analyzed the status of the dysphagia diet and nutrition management by considering the type of hospital.
Results
Among the hospitals surveyed, 167 (77%) provided texture-modified diets for dysphagia patients. The status of providing dysphagia diets and nutrition management for dysphagia differed depending on the institution. In particular, nutrition services for dysphagia patients in long-term care hospitals were poor. Difficulties in providing a dysphagia diet included the complexity of the cooking process, difficulty maintaining constant viscosity, difficulty in hygiene management, and low meal bills. Using commercial thickeners in cooking accounted for 72.5%, and only 41.9% of hospitals provided a commercial thickener with meals. Compared to the regular diet, the additional food cost to provide a single dysphagia diet meal was estimated to be 500-1,000 won. Based on a 5-point scale, we determined that the average scores for the importance and performance of nutrition management in patients with dysphagia were 4.29 and 3.19 points, respectively. Regardless of the type of hospital, performances of all the steps in the nutrition care process were significantly lower than their importance.
Conclusion
Several difficulties are encountered in meal provision and nutrition management for patients with dysphagia, including the burden of expenses and human resources. Thus, the medical fees for a dysphagia diet need to be reasonably increased. Moreover, national health insurance should additionally cover nutrition education for dysphagia patients.

Keyword

Dysphagia; Diet therapy; Food services; Viscosity; Hospitals