The Role of Inpatient Malnutrition Care to Address Health Disparities among Older Adults

Wahid, Naila; Badaracco, Christina; Valladares, Angel F.; Depriest, Ashley; Collins, Alyssa; Mitchell, Kristi

doi:10.1016/j.jand.2022.06.015

Cited by 6 publications

(11 citation statements)

References 20 publications

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“…This prevalence varies depending on the assessment tool, patient population, and data collection and analysis method 22–24 . More recent data published by the Malnutrition Quality Improvement Initiative found that, from a nationwide collaborative, dietitians identified malnutrition in acute care hospitals at a rate of about 24% 25 . When comparing this rate with the 2018 Healthcare Cost and Utilization Project (HCUP) data at 8.9% for nonmaternal, nonneonatal patients and 6.4% in pediatric 2019 HCUP data, 4 a noted difference is apparent 3,4 .…”

Section: Discussionmentioning

confidence: 99%

“…[22][23][24] More recent data published by the Malnutrition Quality Improvement Initiative found that, from a nationwide collaborative, dietitians identified malnutrition in acute care hospitals at a rate of about 24%. 25 When comparing this rate with the 2018 Healthcare Cost and Utilization Project (HCUP) data at 8.9% for nonmaternal, nonneonatal patients and 6.4% in pediatric 2019 HCUP data, 4 a noted difference is apparent. 3,4 These HCUP data analyses show hospitalized patients who had a coded diagnosis of malnutrition on discharge, that is, the diagnosis that makes it to the problem list and claims codes.…”

Section: Malnutrition Diagnosis and Carementioning

confidence: 95%

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Current nutrition assessment practice: A 2022 survey

et al. 2023

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BackgroundMalnutrition remains a significant problem in patients with acute or chronic illnesses. Nutrition assessment is an important component in detecting malnutrition; but not always performed using a standardized tool. This survey on nutrition assessment evaluates current clinical practices on the assessment, diagnosis, and treatment of malnutrition.MethodsThis 2022 survey of US‐based nutrition clinicians collected data on assessment parameters used in hospitals, long‐term care facilities, and the home care setting.ResultsA total of 686 surveys were available for analysis. Ninety‐seven percent of adult and 91% of pediatric responding clinicians indicated that a dietitian completed the assessment. Parameters used most frequently among adult clinician respondents included nutrient intake, current weight, and weight history, those used by pediatric clinician respondents included nutrient intake, weight‐for‐age z score, and weight‐for‐length/height z score. Eighty‐nine percent of adult clinicians in all care settings and 85% of pediatric clinicians use the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Indicators of Malnutrition (AAIM). Respondents reported malnutrition rates of 32%–40% for adults and 4%–30% for pediatric patients, depending on the setting. Appropriate interventions for those with malnutrition (as perceived by the survey respondents) were ordered 70% of the time.ConclusionThis survey demonstrated significant use of the AAIM by both adult and pediatric clinicians across care settings. Reported malnutrition rates are consistent with others published in the literature. The authors suggest that quality improvement efforts should focus on the 30% of patients with malnutrition but without a reported appropriate nutrition intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Malnutrition Diagnosis and Carementioning

confidence: 95%

Current nutrition assessment practice: A 2022 survey

et al. 2023

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“…These data have also shown higher readmission rates for non‐Hispanic Black patients with malnutrition than for non‐Hispanic White patients with malnutrition (Figure 3). 27 Awareness of such disparities is a necessary first step for hospitals to address health disparities.…”

Section: The Gmcs' Potential To Advance Health Equitymentioning

confidence: 99%

“…RDN, registered dietitian nutritionist. Adapted with permission from the Commission on Dietetic Registration 27 …”

Section: The Gmcs' Potential To Advance Health Equitymentioning

confidence: 99%

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Interprofessional implementation of the Global Malnutrition Composite Score quality measure

et al. 2023

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Malnutrition in hospitalized patients can impact health outcomes, quality of life, and health equity. Quality improvement initiatives and quality measurement can help improve the care of those hospitalized patients with malnutrition. The new Global Malnutrition Composite Score (GMCS) was recently adopted by the Centers for Medicare & Medicaid Services (CMS) as a health equity–focused measure. Beginning in 2024, the GMCS is available for reporting through the CMS Hospital Inpatient Quality Reporting Program. The GMCS provides an opportunity to elevate the importance of patient nutrition status and evidence‐based interventions throughout the interdisciplinary hospital decision‐making process. To promote this opportunity, the American Society for Parenteral and Enteral Nutrition (ASPEN) held an “Interprofessional implementation of the Global Malnutrition Composite Score” webinar as part of its 2022 Malnutrition Awareness Week programming. This article summarizes the underlying rationale and significance of the GMCS measure and showcases clinical observations about integrating quality improvement and measurement into the acute care setting, as presented during the webinar.

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Nutrition Security at the Intersection of Health Equity and Quality Care

Blankenship¹,

Blancato²

2022

Journal of the Academy of Nutrition and Dietetics

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The Role of Inpatient Malnutrition Care to Address Health Disparities among Older Adults

Cited by 6 publications

References 20 publications

Current nutrition assessment practice: A 2022 survey

Current nutrition assessment practice: A 2022 survey

Interprofessional implementation of the Global Malnutrition Composite Score quality measure

Nutrition Security at the Intersection of Health Equity and Quality Care

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