Background And Objectives: Lack of professional and accurate diagnosis of malnutrition led to a reduction in Diagnosis Related Group (DRG) payment and a decrease in Case-Mix Index (CMI). The aim of this study was to explore the effects of adding a proper nutritional diagnosis and modifying complication groups on DRG payment and CMI.
Methods And Study Design: Retrospective analysis was performed on patients ad-mitted to the hospital from January to June 2022 who had received a nutritional assessment. Patients were diagnosed as well-nourished, mild malnutrition, moderate malnutrition or severe malnutrition according to patient-generated subjective global assessment (PG-SGA) scores within 24 hours of admission. CMI and DRG hospital internal control standards were recalculated and compared with the original values.
Results: A total of 254 patients were enrolled, including 40 patients with mild malnutrition, 74 patients with moderate malnutrition and 122 patients with severe malnutrition. Of all subjects, 111 changed complication groups. The median of the DRG hospital internal control standard (12006.09 vs. 13797.19, p=0.01) and the median of CMI (0.91 vs. 1.04, p=0.026) were significantly higher than those before the diagnostic change. In patients with inflammatory bowel disease (IBD), the CMI value, hospital control standard of DRG, and the classification of DRG were significantly different from those before diagnosis revision (p<0.001).
Conclusions: Fully identification and correct coding of malnutrition cases are conducive for hospitals to receive appropriate DRG compensation, and further contribute to the improvement of medical quality and the economic sustain-ability of hospitals.
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http://dx.doi.org/10.6133/apjcn.202309_32(3).0007 | DOI Listing |
Hinyokika Kiyo
November 2024
The Department of Urology, Nara Medical University.
A 28-year-old man was diagnosed with chlamydial urethritis by his previous doctor and was prescribed minocycline (MINO). The result of a urinary chlamydia polymerase chain reaction (PCR) test later confirmed to be negative. However, the patient visited our hospital because of persistent miction pain.
View Article and Find Full Text PDFAnn Biomed Eng
December 2024
Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden.
Vacuum-assisted delivery (VAD) uses a vacuum cup on the fetal scalp to apply traction during uterine contractions, assisting complicated vaginal deliveries. Despite its widespread use, VAD presents a higher risk of neonatal morbidity compared to natural vaginal delivery and biomechanical evidence for safe VAD traction forces is still limited. The aim of this study is to develop and assess the feasibility of an experimental VAD testing setup, and investigate the impact of traction forces on fetal brain deformation.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Neurosurgery, Neuromedicine Center, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038, People's Republic of China.
Background: Full-endoscopic microvascular decompression (fE-MVD) is an emerging treatment option for trigeminal neuralgia (TN). However, the risk factors associated with postoperative recurrence of TN after fE-MVD procedure remain controversial. The aim of the present study was to summarize the surgical technique of fE-MVD for the treatment of TN and to develop a predictive model for recurrence at 1 year postoperatively based on independent risk factors.
View Article and Find Full Text PDFLangenbecks Arch Surg
December 2024
Department of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Objective: Splenectomy is regularly performed in total and distal pancreatectomy due to technical reasons, lymph node dissection and radicality of the operation. However, the spleen serves as an important organ for competent immune function, and its removal is associated with an increased incidence of cancer and a worse outcome in some cancer entities (Haematologica 99:392-398, 2014; Dis Colon Rectum 51:213-217, 2008; Dis Esophagus 21:334-339, 2008). The impact of splenectomy in pancreatic cancer is not fully resolved (J Am Coll Surg 188:516-521, 1999; J Surg Oncol 119:784-793, 2019).
View Article and Find Full Text PDFSkeletal Radiol
December 2024
Department of Orthopedic Surgery, Akita Hospital, 2-6-12 Takara, Chiryu City, Aichi, 472-0056, Japan.
Objective: To determine which parameters, including femur morphology, proximal femur bone mineral density, or patient characteristics, are associated with bisphosphonate-related atypical femur fractures (AFFs) and to investigate the relationships between AFF location and these parameters.
Materials And Methods: Sixteen females with a history of bisphosphonate use who presented with AFFs and 38 females without AFFs, even those with long-term bisphosphonate use of > 5 years, were compared. Patient characteristics; physique, gait ability, and history of pain and medication, were recorded.
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