RT Journal Article
T1 The economic cost of not coding disease-related malnutrition: A study in cancer inpatients.
A1 Ruiz-Garcia, Ignacio
A1 Contreras-Bolivar, Victoria
A1 Sanchez-Torralvo, Francisco Jose
A1 Ulloa-Diaz, Osmayda
A1 Ruiz-Vico, Maria
A1 Abuin-Fernandez, Jose
A1 Barrios-Garcia, Manuel
A1 Alba-Conejo, Emilio
A1 Olveira, Gabriel
K1 Coding
K1 Costs
K1 Disease-related malnutrition
K1 Oncology
K1 Reimbursement
K1 Subjective global assessment
AB Disease-related malnutrition (DRM) coding rate is usually low in hospitalised patients. The objective of our study was to estimate the percentage of correct DRM coding in cancer inpatients and to calculate the economic losses caused by such lack of coding. This was an observational, prospective study that was conducted in patients hospitalised in the Medical Oncology Unit of our hospital. A nutritional assessment was performed through subjective global assessment (SGA). The all patient refined-diagnosis related group (APR-DRG) weights were obtained at the moment of discharge; moreover, recalculation was done after including the diagnosis of malnutrition in the medical record of those patients in whom it had not been initially coded. The associated cost reimbursement were calculated based on the weight before and after revising the diagnosis of DRM. A total of 266 patients were evaluated. From them, 220 (82.7%) suffered from DRM according to the SGA. In 137 (51.5%) of these patients, diagnosis was coded, as opposed to 83 (31.2%) cases (33 subjects with moderate and 50 with severe DRM) in whom it was not coded. The sum of the APR-DRG weights before revising the diagnosis of malnutrition was 343.4 points (mean: 1.29 ± 0.89). Whereas, after revising the diagnosis, it increased up to 384.3 (1.44 ± 0.96). The total cost reimbursement for the hospital before revising the diagnosis of malnutrition was 1,607,861.21€ and after revision it increased up to 1,799,199.69€, which means that 191,338.48€ were not reimbursed to the hospital due to the lack of coding of malnutrition. The cost reimbursement for each admission increased an average of 719.32€. The prevalence of DRM in cancer inpatients is high. Nevertheless, the diagnosis is not coded in one third of patients, which results in important economic losses for the hospitals.
PB Elsevier BV
YR 2021
FD 2021-11-22
LK http://hdl.handle.net/10668/22111
UL http://hdl.handle.net/10668/22111
LA en
NO Ruiz-García I, Contreras-Bolívar V, Sánchez-Torralvo FJ, Ulloa-Díaz O, Ruiz-Vico M, Abuín-Fernández J, et al. The economic cost of not coding disease-related malnutrition: A study in cancer inpatients. Clin Nutr. 2022 Jan;41(1):186-191.
NO This study was partially funded by an unrestricted grant from Abbott Laboratories SA (Spain). Ignacio Ruiz-García holds a Río Hortega CM20/00225 contract from the Carlos III National Health Institute, cofunded by the European Social Fund 2014-2020, “The FSE invests in your future.” Victoria Contreras Bolívar holds a postdoctoral grant from the Andalusian Government (Junta de Andalucía) (RH-0141-2020). Funding for the open access charge was provided by the Universidad de Málaga / CBUA.
DS RISalud
RD Apr 9, 2025