Current Practices and Perceived Barriers to Diagnosing, Documenting, and Coding for Malnutrition: A Survey of the Dietitians in Nutrition Support Dietetic Practice Group.

Malnutrition is a prevalent condition among hospitalized patients worldwide. Approximately 30% to 50% of patients are malnourished. 1 Barker L.A. Gout B.S. Crowe T.C. Hospital malnutrition: Prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health. 2011; 8: 514-527 Crossref PubMed Scopus (436) Google Scholar , 2 Lim S.L. Ong K.C. Chan Y.H. Loke W.C. Ferguson M. Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012; 31: 345-350 Abstract Full Text Full Text PDF PubMed Scopus (495) Google Scholar , 3 Norman K. Pichard C. Lochs H. Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008; 27: 5-15 Abstract Full Text Full Text PDF PubMed Scopus (820) Google Scholar , 4 Christensen K.S. Gstundtner K.M. Hospital-wide screening improves basis for nutrition intervention. J Am Diet Assoc. 1985; 85: 704-706 PubMed Google Scholar , 5 Chima C.S. Barco K. Dewitt M.L. Maeda M. Teran J.C. Mullen K.D. Relationship of nutritional status to length of stay, hospital costs, and discharge status of patients hospitalized in the medicine service. J Am Diet Assoc. 1997; 97: 975-978 Abstract Full Text Full Text PDF PubMed Scopus (243) Google Scholar Malnutrition is associated with negative clinical outcomes, including delayed wound healing, immune dysfunction, infections, and prolonged length of hospital and intensive care unit stays. 6 Alberda C. Gramlich L. Jones N. et al. The relationship between nutritional intake and clinical outcomes in critically ill patients: Results of an international multicenter observational study. Intensive Care Med. 2009; 35: 1728-1737 Crossref PubMed Scopus (624) Google Scholar , 7 Corkins M.R. Guenter P. DiMaria-Ghalili R.A. et al. Malnutrition diagnoses in hospitalized patients: United States, 2010. JPEN J Parenter Enteral Nutr. 2014; 38: 186-195 Crossref PubMed Scopus (139) Google Scholar , 8 Lim S.S. Vos T. Flaxman A.D. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380: 2224-2260 Abstract Full Text Full Text PDF PubMed Scopus (7573) Google Scholar More resources and care are required for these patients, resulting in increased hospital costs. In the United States, the estimated cost of disease-associated malnutrition is $157 billion/yr. 9 Snider J.T. Linthicum M.T. Wu Y. et al. Economic burden of community-based disease-associated malnutrition in the United States. JPEN J Parenter Enteral Nutr. 2014; 38: 77S-85S Crossref PubMed Scopus (49) Google Scholar