Resumo

BALLESTEROS POMAR, María D. et al. Influence of an appropriate coding of disease-related malnutrition in clinical indexes. Nutr. Hosp. [online]. 2016, vol.33, n.1, pp.86-90. ISSN 1699-5198.  https://dx.doi.org/10.20960/nh.24.

Introduction: Disease related malnutrition (DRM) affects at least one in four inpatients, increasing both morbidity and mortality during admission and after discharge. Nevertheless, its repercussion on hospital activity is not properly quantified. Objective: To determine the impact of an adequate coding of DRM and procedures employed to reverse it in the hospital average weight and other hospital indicators. Methods: Comparative study carried out in every patients requiring nutritional support and followed up by the Clinical Nutrition and Dietetics Unit of the Endocrinology and Nutrition Department in Complejo Asistencial Universitario de León (Spain) in 2008 and 2013. A nutritional coding report at discharge including diagnosis, nutritional treatment and access was performed following ICD-9-MC. Average weight, average length of stay adjusted by case-mix and case-mix index were compared before and after coding. Results: Hospital average weight increased after coding, both in 2008 (+4.1%) and 2013 (+1.7%) and especially in those departments in which nutritional screening is performed (Hematology, +10.5%). Average length of stay adjusted by case-mix was reduced under 1 (-5.7% and -0.2% in 2008 y 2013), pointing out to better functioning, and functioning index also decreased (-5.6% y -0.4% in 2008 and 2013), what means a higher efficiency. Conclusion: Adequate coding of nutritional diagnosis and treatment of patients with DRM increases the average weight of our hospital and improves average length of stay adjusted by case-mix and functioning index.

Palavras-chave : Clinical coding; Malnutrition; Nutritional support; Patient care management; Diagnosis.

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