Background/Objectives: The semi-solid enteral nutrition method, in which semi-solid nutrients are administered through a gastrostoma rather than liquid nutrients, is a medical technology for nutritional management developed in Japan. This nutritional method has spread rapidly, and in 2018, the Home Semi-solid Enteral Nutrition Guidance and Management fee was newly established in the payment system for medical services. However, there are few studies evaluating this nutrition method in actual clinical practice. Methods: Using the DeSC medical claims database, we investigated patient characteristics, the number of fee calculations, and the length of hospital stay for all hospitalizations and for pneumonia during and after fee calculation. Results: Home semi-solid enteral nutrition guidance and management was received at least once by 3105 patients (mean age: 79.4 years). Cerebrovascular disease, nervous system disease, dementia, and pneumonia were the most common diseases at the start of guidance and management, and the mean number of sessions received was 7.7. The mean length of stay for any hospitalization was significantly shorter during the guidance and management period than after the last guidance and management session (8.2 vs. 29.1 days). Notably, the mean length of hospital stay for pneumonia was also significantly shorter during the guidance and management period than after the last guidance and management session (3.1 vs. 10.2 days). Conclusions: This study clarified the calculation status of the Home Semi-solid Enteral Nutrition Guidance and Management fee and outcomes of patients who received this guidance and management. These findings suggest that the provision of this guidance and management may be associated with the shorter length of hospital stay. However, because residual confounding cannot be ruled out, a causal relationship cannot be established. Overall, the provision of this guidance and management may be associated with maintaining stable home care.

Background/Objectives: The semi-solid enteral nutrition method, in which semi-solid nutrients are administered through a gastrostoma rather than liquid nutrients, is a medical technology for nutritional management developed in Japan. This nutritional method has spread rapidly, and in 2018, the Home Semi-solid Enteral Nutrition Guidance and Management fee was newly established in the payment system for medical services. However, there are few studies evaluating this nutrition method in actual clinical practice. Methods: Using the DeSC medical claims database, we investigated patient characteristics, the number of fee calculations, and the length of hospital stay for all hospitalizations and for pneumonia during and after fee calculation. Results: Home semi-solid enteral nutrition guidance and management was received at least once by 3105 patients (mean age: 79.4 years). Cerebrovascular disease, nervous system disease, dementia, and pneumonia were the most common diseases at the start of guidance and management, and the mean number of sessions received was 7.7. The mean length of stay for any hospitalization was significantly shorter during the guidance and management period than after the last guidance and management session (8.2 vs. 29.1 days). Notably, the mean length of hospital stay for pneumonia was also significantly shorter during the guidance and management period than after the last guidance and management session (3.1 vs. 10.2 days). Conclusions: This study clarified the clinical status and outcomes of patients who received Home Semi-solid Enteral Nutrition Guidance and Management. The results suggested that application of the semi-solid enteral nutrition method can contribute to stable patient home care.

Malnutrition is known to worsen the prognosis of chronic heart failure (HF). To gain information that may be helpful in establishing appropriate nutritional interventions for chronic HF, this study was performed to investigate the efficacy of nutritional management with 2 enteral formulas, EH, with a standard nutritional composition, and ER, fortified with omega-3 fatty acids, vitamin D, and carnitine. Experiments were performed in a Dahl rat HF model. After being fed a standard rodent feed (MF) containing 8% NaCl (high salt-MF [HS-MF]) from 6 to 11 weeks of age, rats were assigned to freeze-dried EH or ER diets with an NaCl concentration of 8% (HS-ER or HS-EH) until 18 weeks of age. Serum albumin was significantly higher at 14 and 17 weeks of age in rats fed the HS-ER and HS-EH diets compared with those remaining on the HS-MF diet. Body weight was also significantly higher at 14 and 17 weeks of age in animals fed the HS-ER diet, showing that nutritional deterioration was prevented. In addition, heart weight was significantly lower at 18 weeks of age in the HS-ER group than that in the HS-MF group, suggesting that cardiac hypertrophy was prevented. This study demonstrated improved nutritional status in a HF model in Dahl rats presumably owing to differences in nutritional composition in the diets. Future studies are needed to explore optimal nutritional management with enteral formulas in patients with chronic HF.