The economic impact of disease-related malnutrition at hospital admission.
OBJECTIVE
The reported frequency of disease-related malnutrition (DRM) for patients admitted to hospitals has been shown to be high, but an accurate estimate of the magnitude of its economic costs is lacking. The objective of this study was to determine the impact of DRM on hospitalization costs.


METHODS
A probabilistic sample of 469 (50%) patients from two hospitals was recruited on a cross-sectional study. DRM was evaluated by the Nutritional Risk Screening-2002 instrument at hospital admission and hospitalization costs were calculated for each patient based on hospital length of stay and on the discharge diagnosis-related group (DRG) code. Estimates of the association between DRM and deviations from the mean cost within each DRG were carried out.


RESULTS
Patients classified as nutritionally-at-risk accounted for 42% of the sample. Multivariate estimates of the determinants of cost deviation shows that the cost of treating a nutritionally-at-risk patient is 20% higher than the average of the respective DRG. Patients that are classified on DRG classes that have a higher relative weight are less likely to end up with hospitalization costs above the mean.


CONCLUSIONS
Considering this sample case-mix, DRM can represent an increase in costs of 19.3%, or between 200 and 1500 euros, with a confidence of 95%.
Amaral
Teresa F
TF
Faculty of Nutrition and Food Sciences, University of Porto, Portugal. amaral.tf@gmail.com
Matos
Luís C
LC
Tavares
Maria M
MM
Subtil
Ana
A
Martins
Rosário
R
Nazaré
Margarida
M
Sousa Pereira
Nuno
N
D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000191:economics* / Q000209:etiology; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D011174:Portugal; D011787:Quality of Health Care; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors