Vonzun Nick, Rühlin Maya, Sterchi Anna
Ernährungsberatung Kantonsspital Graubünden.
Ernährungsberatung Kantonsspital Winterthur.
Ther Umsch. 2014 Mar;71(3):185-9. doi: 10.1024/0040-5930/a000501.
Malnutrition in hospital patients is of important medical and economic significance. The adverse consequences of malnutrition on quality of life and many more factors such as morbidity, mortality, tolerance of treatments and length of hospital stay are well documented in the medical literature. Nevertheless, the effects of malnutrition are still often underestimated and hence malnutrition is not recognised as a distinct diagnosis. Moreover, malnutrition is rarely documented in medical reports and often not adequately treated with adverse effects. The reason for this neglectfulness are diverse, e. g. inadequate training of doctors and nurses in clinical nutrition and lack of sensibilisation of the hospital staff for the problem of malnutrition. Therefore, a systematic screening for malnutrition is rarely undertaken in Swiss hospitals. The introduction of the Swiss-DRG system (DRG, diagnosis related groups) in January 2012 gave the chance to boost recording and to document malnutrition in a standardised way in the patient history, and to code precisely malnutrition as a distinct diagnosis. Moreover, this approach allowed to document the specific nutritional therapy. Here, we describe the way of documenting and coding malnutrition in the Swiss-DRG system and the medical and economic consequences of this procedure.
医院患者的营养不良具有重要的医学和经济意义。营养不良对生活质量以及发病率、死亡率、治疗耐受性和住院时间等诸多因素的不利影响在医学文献中有充分记载。然而，营养不良的影响仍常常被低估，因此营养不良未被视为一种明确的诊断。此外，营养不良在医学报告中很少被记录，而且往往没有得到充分治疗，存在不良影响。这种忽视的原因多种多样，例如医生和护士在临床营养方面的培训不足，以及医院工作人员对营养不良问题缺乏认识。因此，瑞士医院很少进行系统的营养不良筛查。2012年1月引入的瑞士疾病诊断相关分组系统（DRG）提供了一个机会，以促进在患者病历中以标准化方式记录和记录营养不良情况，并将营养不良准确编码为一种明确的诊断。此外，这种方法还允许记录特定的营养治疗。在此，我们描述在瑞士DRG系统中记录和编码营养不良的方式以及这一过程的医学和经济后果。
