Observational studyJournal of evaluation in clinical practice2026
Changes in Hospital Malnutrition Coding Following Diagnosis-Related Group Payment Reform: Evidence From a Chinese Tertiary Hospital.
Observational study in Journal of evaluation in clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
rationaleMalnutrition remains systematically undercoded in hospital administrative records, despite its high prevalence among patients with non-communicable diseases (NCDs). China's Diagnosis-Related Group (DRG) payment reform links reimbursement to secondary diagnosis coding, potentially incentivising changes in clinical documentation. AIMS AND
objectivesThis study evaluates the validity of administrative malnutrition coding and its association with clinical outcomes in the context of DRG reform.
methodA retrospective cross-sectional study was conducted using administrative data from a tertiary hospital in southwest China (2023-2025), including 31,133 inpatient admissions with a primary NCD diagnosis. Patients were categorised by insurance type: Urban and Rural Residents' Basic Medical Insurance (URRBMI) or Urban Employees' Basic Medical Insurance (UEBMI). Multivariable logistic regression was used to identify predictors of malnutrition coding and estimate associations with in-hospital mortality and prolonged hospitalisation (LOS > 10 days), adjusting for age, insurance, admission route, and primary diagnosis.
resultsThe prevalence of coded malnutrition was 8.5%, surging from 5.3% in 2023% to 11.0% in 2024 before stabilizing at 9.2% in 2025. After case-mix adjustment, the year of admission remained a significant predictor (2024: OR = 2.23; 2025: OR = 1.71). Coded malnutrition independently predicted in-hospital mortality (OR = 4.35) and prolonged hospitalisation (OR = 1.32). URRBMI patients consistently demonstrated higher coding rates, while the association between malnutrition coding and mortality was stronger in UEBMI patients.
conclusionMalnutrition coding increased markedly following DRG reform. The robust association with adverse clinical outcomes validates these codes as meaningful markers of nutritional risk. Our findings underscore the need for systematic nutritional screening in hospital admission protocols to ensure equitable and clinically accurate reimbursement.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.