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New Research Finds U.S. Hospitals Markedly Underreporting Patient Malnutrition

SILVER SPRING, Md., Nov. 20, 2013 /PRNewswire-USNewswire/ -- While previous studies have suggested that malnutrition is present in between 21% and 54% of hospitalized patients, new research, published in the Journal of Parenteral and Enteral Nutrition, finds that only 3.2% of U.S. hospital patients were given a diagnosis of malnutrition.

This new study and prior studies do agree, however, that malnutrition is associated with unfavorable outcomes including higher infection rates, poor wound healing, longer length of stay, and higher frequency of readmission of patients.

"While there is no question that malnutrition can be devastating to a patient's well-being, many questions remain about how to assure patients are properly diagnosed," said Mark R. Corkins, MD, CNSC, of University of Tennessee Health Science Center/Le Bonheur Children's Hospital and lead researcher on the study.

This new study analyzed 2010 data from the U.S. Department of Health & Human Services sponsored Healthcare Cost and Utilization Project (HCUP), which contains representative data for all U.S. hospitalizations. The HCUP data set contains up to twenty-five ICD-9 diagnosis codes for each discharged patient.  Using these codes, all patients with a diagnosis of malnutrition in their hospital records were identified.  Based on the reported ICD-9 codes a much smaller proportion of malnourished hospital patients were identified than previous studies that used specialized assessment instruments and selected at-risk populations.

The discrepancy between the new study and prior studies is likely due to inadequate diagnosis and coding of malnutrition in hospitalized patients. There is currently no national benchmarking of malnutrition in acute care hospitals in the U.S.

The current study's authors agree that standard malnutrition screening and assessment tools should be used to monitor malnutrition rates.  If implemented, a program of this type not only has the potential to generate much more accurate data on annual rates of malnutrition, but it could also enhance quality of patient care and address pressing public policy issues such as rehospitalization.

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