Auswirkung der Kodierung der Mangelernährung im SwissDRG-System

Aeberhard, Carla; Abt, Mirjam; Endrich, Olga; Aubry, Emilie; Leuenberger, Michèle Simone; Schütz, Philipp; Sterchi, Anna-Barbara; Stanga, Zeno (2018). Auswirkung der Kodierung der Mangelernährung im SwissDRG-System. Aktuelle Ernährungsmedizin, 43(02), pp. 92-100. Thieme 10.1055/a-0595-2481

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Abstract
Background Disease-related malnutrition (DRM) in hospitals is a frequent problem with medical and economic consequences. The present four-years-analysis shows whether the expenses for nutritional therapies of malnourished patients get covered by the surplus, which is attained from the encoding of DRM in the SwissDRG-system.
Material and Methods All inpatients with an E 4-diagnosis of the University Hospital of Bern were analyzed in this data collection (2013 – 2016). The E-diagnosis, diagnosis, length of hospital stay, age, type of nutritional therapy, surplus and costs generated by the nutritional treatment were considered. The expenses for the nutrition counseling, care and nutritional therapies were extrapolated. Further, the patients were divided into 12 groups (based on the ICD-10 classification of the WHO), due to their principal diagnosis.
Results Of the 169515 inpatients in the observed four years, 5442 cases (3.2 %) were coded as malnourished. Only 462 cases (8.5 %) increased the relative weight, and hence, the amount of total reimbursement of the assigned DRM. Of the 5442 patients, 3211 (59 %) received oral nutritional supplements, 1578 (29 %) enteral nutrition and 654 (12 %) parenteral nutrition. The encoding of DRM amounted to a surplus of total CHF 3 494 081 and an effort of extrapolated CHF 2 803 432. Oncological patients were most often encoded with DRM (n = 1708, 31.4 %), followed by patients with diseases of the digestive system (n = 671, 12.3 %) and of the circulatory system (n = 609, 11.2 %).
Conclusion This analysis shows, that the surplus generated by the encoding of DRM in the SwissDRG-system, covers the financial effort resulting from nutritional therapies. The consequent and early assessment, treatment and encoding of DRM lead to a high treatment quality and patient safety and is economically viable for the hospital.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Aeberhard, Carla; Reber-Aubry, Emilie; Leuenberger, Michèle Simone; Sterchi, Anna-Barbara and Stanga-Nodari, Zeno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0341-0501

Publisher:

Thieme

Language:

German

Submitter:

Andreas Melmer

Date Deposited:

20 Aug 2019 08:45

Last Modified:

25 Sep 2020 14:10

Publisher DOI:

10.1055/a-0595-2481

BORIS DOI:

10.7892/boris.126224

URI:

https://boris.unibe.ch/id/eprint/126224

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