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PAM12 ESTIMATING EXCESS HEALTHCARE COSTS OF MALNOURISHED PATIENTS IN A LEARNING COLLABORATIVE OF U.S. HOSPITALS

      Objectives

      Malnutrition carries significant economic burden to the U.S. healthcare system. This study extrapolates excess costs using national cost estimates, associated with increased length of stay (LOS) and 30-day readmissions experienced by patients with a malnutrition diagnosis compared to non-malnourished patients in a real-world sample of 56 U.S. hospitals.

      Methods

      We identified two cohorts of patients using ICD-10-CM codes: 421,125 patients and 296,023 patients, with a variable tag of LOS and 30-day readmission, respectively. Both cohorts included 26,428 patients with a medical diagnosis of malnutrition ≥ 18 years-old upon admission. A 2016 national claims-based analysis by the Healthcare Cost and Utilization Project calculated costs for 1.45M inpatients with malnutrition in 2016, representing 5.27% of the 27.6 million total non-maternal and non-neonatal stays. To evaluate the total excess costs among malnourished patients to the healthcare system, we calculated excess cost per patient associated with increased LOS and 30-day readmissions ($12,635 and $3,700, respectively) and extrapolated that over the total patient cohorts.

      Results

      Our analysis indicates that a medical malnutrition diagnosis amounts to excess costs of $333.92M and $16.86M, associated with increased LOS and readmission within 30 days of discharge, respectively. Our data shows 82.76% of malnourished patients were above the median LOS, compared to 47.79% of non-malnourished patients who were above the median LOS (p-<0.0001). Average readmission rate among malnourished patients is 17.24%, compared to non-malnourished patients with an average readmission rate of 9.24%, (p<.0001).

      Conclusions

      Our analysis using a first of its kind aggregate real-world dataset of patients identified with malnutrition supports previously reported claims data demonstrating the excess costs associated with malnutrition in hospitalized adults. These findings support the need for a call to policymakers to adopt policies incentivizing providers to focus on these patients. Identifying and treating malnutrition may provide substantial savings to the U.S. healthcare system.