Impact of Intensity of Nutrition Intervention Within Diagnosis-Related Groups

A retrospective study of 3,882 Diagnosis-Related Group [DRG] inpatients, of whom 828 received nutrition intervention, during the time period of January 1 through December 31, 1988, was conducted on a 240-bed acute-care, medical/surgical, community-based hospital. The purpose of the research was threefold: [1] to determine the intensity of nutrition intervention [i.e., total time required by a dietitian or dietitians' assistant for basic and non-basic care over the patient's entire length of stay [LOS], [2] to determine the number of DRG inpatients who received nutrition intervention along with the top Medical Disease Categories [MCDs] and DRGs, and [3] to explore the relationships among the timing and intensity of nutrition intervention, and LOS. The researcher classified each patient with nutrition intervention into one of four care levels as developed by Lutton, Baker, and Billman.

The results revealed that, as nutrition intensity [i.e., time] increased, a decline in LOS was evident from care level one [i.e., basic care] through care level three but not for care level four. Statistical significance among the care level means of the 24 MDC categories and 59 groups-related, selected DRGs was noted. When the DRGs were classified as medical or surgical DRGs, nutrition intervention was 50 to 100% earlier for the medical DRGs.

The research provided a basis for [1] evaluating the time intensity required within specific DRGs, [2] determining the component of care that could be delegated to dietetic technicians, and [3] potentially, assessing clinical staffing requirements base on care levels, time and type of DRG.