Abstract

MORAN LOPEZ, Jesús Manuel et al. Impact of adequate coding of undernutrition and nutritional procedures on case-mix index in medical and surgical pathologies. Nutr. Hosp. [online]. 2016, vol.33, n.1, pp.64-69. ISSN 1699-5198.  https://dx.doi.org/10.20960/nh.19.

Introduction: Group-related diagnosis classification system allows ordering medical and surgical procedures following a similar expenditure of economical resources. Complexity of procedures according to the case-mix index permits asking for a minor o major economical reimbursement of the expenditure in patients' attention. Undernutrition documentation can increase case-mix index, but it is barely detected and documented. Aim: Determine if proper documentation of undernutrition is able to enhance the case-mix index and establish if it is dependent on documentation by a specialist on clinical nutrition, the type of procedure or the service where the patient is admitted. Results: In a randomized simple of 100 procedures, documentation of undernutrition and nutritional support procedures by a specialist in Clinical Nutrition increased the case-mix index in 0.68 points (IC₉₅: 0.48-0.88). Impact of documentation was higher on medical than surgical procedures (0.42 points [IC₉₅: 0.03-0.81]). Impact was also positive on patients admitted at general surgery and internal medicine. Sample size for other services was not high enough to establish differences. Conclusion: Investment on human resources (specialists in Clinical Nutrition) is feasible in terms of economic management due to the increase of the case-mix index dependent on specialist's documentation in a real clinical practice, not in a research environment.

Keywords : Malnutrition; Underdiagnosis; Case-mix index.

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