Characteristics of Hospitalized Children With a Diagnosis of Malnutrition: United States, 2010
Ruba A Abdelhadi1, Sandra Bouma2, Sigrid Bairdain3
1Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA ruba_md@yahoo.com.
Insights
Hospitalized children with a coded diagnosis of malnutrition (CDM) experience longer stays and higher costs. Accurate malnutrition coding is crucial for understanding its true prevalence and resource needs.
Area of Science:
- Pediatrics
- Public Health
- Healthcare Management
Background:
- Malnutrition is a significant issue among hospitalized children in the U.S.
- In 2010, over 80,000 children under 17 had a coded diagnosis of malnutrition (CDM).
Purpose of the Study:
- To summarize the characteristics of hospitalized children with a coded diagnosis of malnutrition (CDM).
- To analyze the impact of malnutrition on healthcare resource utilization in pediatric hospitalizations.
Main Methods:
- Utilized 2010 Healthcare Cost and Utilization Project (HCUP) data for U.S. hospital inpatient stays.
- Analyzed patient-level data, including up to 25 ICD-9-CM diagnostic codes, to identify children with a CDM.
Main Results:
- 1.3% of hospitalized children under 17 had a CDM in 2010, potentially underrepresenting true prevalence.
- Children with a CDM had 2.5 times longer hospital stays and over 3 times higher costs.
- Malnourished children were less likely to have routine discharge and 3.5 times more likely to need post-discharge home care, with higher comorbidity rates.
Conclusions:
- Hospitalized children with a CDM have increased comorbidities, longer stays, and higher healthcare costs.
- Undernourished children consume more healthcare resources, necessitating consideration in planning.
- Accurate identification and coding of malnutrition are vital for resource allocation and understanding prevalence.
Introduction:
Malnutrition is common in hospitalized patients in the United States. In 2010, 80,710 of 6,280,710 hospitalized children <17 years old had a coded diagnosis of malnutrition (CDM). This report summarizes nationally representative, person-level characteristics of hospitalized children with a CDM.
Methods:
Data are from the 2010 Healthcare Cost and Utilization Project, which contains patient-level data on hospital inpatient stays. When weighted appropriately, estimates from the project represent all U.S. hospitalizations. The data set contains up to 25 ICD-9-CM diagnostic codes for each patient. Children with a CDM listed during hospitalization were identified.
Results:
In 2010, 1.3% of hospitalized patients <17 years had a CDM. Since the data include only those with a CDM, malnutrition's true prevalence may be underrepresented. Length of stay among children with a CDM was almost 2.5 times longer than those without a CDM. Hospital costs for children with a CDM were >3 times higher than those without a CDM. Hospitalized children with a CDM were less likely to have routine discharge and almost 3.5 times more likely to require postdischarge home care. Children with a CDM were more likely to have multiple comorbidities.
Conclusions:
Hospitalized children with a CDM are associated with more comorbidities, longer hospital stay, and higher healthcare costs than those without this diagnosis. These undernourished children may utilize more healthcare resources in the hospital and community. Clinicians and policymakers should factor this into healthcare resource utilization planning. Recognizing and accurately coding malnutrition in hospitalized children may reveal the true prevalence of malnutrition.
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