准确描述营养不良诊断反映医疗资源利用增加

　　营养支持专家常常关注病情最重的住院患者。理解医疗付费模式有助于营养支持专家了解关注营养状态如何保证资源最大程度地用于这些患者。医疗保险是美国许多医院主要的资金来源。医院采用急性护理医院住院患者预付费制度接受付费，这个制度将患者按照疾病严重程度诊断相关组（MS-DRG）分类来确定支付费用。记录合并症和并发症会使支付给医院的费用增加，以抵消医疗资源利用的增加。本文解释了营养不良记录和编码如何影响病例组合指数，该指数反映在医院接受治疗的患者病情严重程度及支付给医院照顾患者的费用。

Nutr Clin Pract. 2015;30(5):604-8.

Accurate Documentation of Malnutrition Diagnosis Reflects Increased Healthcare Resource Utilization.

Phillips W.

Morrison Healthcare, Crozet, Virginia.

Nutrition support professionals often care for the sickest of hospitalized patients. An understanding of healthcare payment models can help the nutrition support professional know how documentation of nutrition status can ensure maximum resources are available to care for these patients. Medicare is the major funding source for many hospitals in the United States. Hospitals receive payments using the Acute Care Hospital Inpatient Prospective Payment System, which classifies patients into Medical Severity Diagnosis-Related Groups (MS-DRGs) to determine payment amounts. Documentation of comorbidities and complications can increase the payment hospitals receive to offset increased resource utilization. This article explains how malnutrition documentation and coding can influence the case mix index, an indicator of level of acuity of patients treated at the hospital, and the payment the hospital receives to care for the patient.

KEYWORDS: Diagnosis-Related Groups; Medicare; fee-for-service plans; insurance; nutrition assessment; nutrition therapy; prospective payment system

PMID: 26084509

DOI: 10.1177/0884533615589372

翻译：天津市第三中心医院营养科肖慧娟