AHRQ Stats: Malnutrition Hospital Stays
Nearly 2 million hospital stays involved malnutrition among adults and children in 2013, accounting for 4.5 percent of all inpatient stays. The rate of malnutrition stays was highest among African-Americans and lowest among Hispanics. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #210: Characteristics of Hospital Stays Involving Malnutrition, 2013.)
Audrey J. Weiss, Ph.D., Kathryn R. Fingar, Ph.D., M.P.H., Marguerite L. Barrett, M.S., Anne Elixhauser, Ph.D., Claudia A. Steiner, M.D., M.P.H., Peggi Guenter, Ph.D., R.N., and Mary Hise Brown, Ph.D.
Undernutrition is a form of malnutrition characterized by a lack of adequate calories, protein, or other nutrients needed for tissue maintenance and repair.1 Malnutrition (undernutrition) occurs among approximately 3 percent of adult hospital inpatient stays in the United States and is associated with increased morbidity, mortality, and health care costs.2 Adult hospitalizations with a diagnosis of malnutrition have a longer length of stay, higher costs, more comorbidities, and 5 times the likelihood of death, compared with other adult hospital stays.3
Evidence suggests that early nutritional intervention may reduce complication rates, mortality, and resource use associated with malnutrition. However, many cases of malnutrition are unrecognized and untreated.4 Clinical definitions of malnutrition and the set of diagnostic codes used to identify malnutrition in hospital administrative data have varied.5 Standardizing definitions and treatment protocols for malnutrition is complicated by the fact that its etiology is heterogeneous. Malnutrition may result from chronic starvation and conditions such as anorexia, but it also may be a consequence of acute and chronic illness or injury.6,7 Using a consistent set of diagnostic criteria and understanding the diseases that are associated with malnutrition are important for recognizing and treating malnutrition, as well as tracking its incidence, prevalence, and outcomes.8
This Healthcare Cost and Utilization Project (HCUP) Statistical Brief presents national estimates on the characteristics of malnutrition reported during nonmaternal and nonneonatal hospital inpatient stays in 2013. Although malnutrition can include high caloric intake associated with overweight and obesity when defined broadly as nutritional imbalance, this Statistical Brief examines undernutrition only.
Malnutrition was identified using a broad set of diagnostic codes that included the following six categories:
Hospital stays involving malnutrition, 2013
Figure 1 provides the distribution of six types of malnutrition among hospital inpatient stays in 2013.
Figure 1. Types of malnutrition among hospital stays with malnutrition, 2013
*Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2013