Shortfalls in malnutrition coding : a mandate for action

The International Classification of Diseases, Version 10, Australian modification (ICD-10- AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI < 18.5 kg/m2 or unintentional weight loss of ≥ 5% with evidence of suboptimal intake resulting in subcutaneous fat loss and/or muscle wasting”. The Australasian Nutrition Care Day Survey (ANCDS) is the most comprehensive survey to evaluate malnutrition prevalence in acute care patients from Australian and New Zealand hospitals1. This study determined if malnourished participants were assigned malnutritionrelated codes as per ICD-10-AM. The ANCDS recruited acute care patients from 56 hospitals. Hospital-based dietitians evaluated participants’ nutritional status using BMI and Subjective Global Assessment (SGA). In keeping with the ICD-10-AM definition, malnutrition was defined as BMI <18.5kg/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32% (n= 993) of the cohort (N= 3122), a significantly small number were coded for malnutrition (n= 162, 16%, p<0.001). In 21 hospitals, none of the malnourished participants were coded. This is the largest study to provide a snapshot of malnutrition-coding in Australian and New Zealand hospitals. Findings highlight gaps in malnutrition documentation and/or subsequent coding, which could potentially result in significant loss of casemix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.

Mandate for remote sensing education and the remote sensing core curriculum

Consensus was developed by the remote sensing community during the 1980s and early 1990s regarding the need for an organized approach to teaching remote sensing fundamentals for collegiate institutions. Growth of the remote sensing industry might be seriously hampered without concerted efforts to bolster the capacity to teach state-of-the-practice remote sensing theory and practice to the next generation of professionals. A concerted effort of educators, researchers, government, and industry began in 1992 to meet these demands leading to the creation of the Remote Sensing Core Curriculum. The RSCC is currently sustained by cooperative efforts of the ASPRS, ICRSE, NASA, NCGIA, and others in the remote sensing community. Growth of the RSCC into the K-12 community resulted from its Internet teaching foundation that enables comprehensive and response reference links to the whole of the education community.

The Law and Economics of the Civil Law of Mandate

Présentation à la Annual Law & Economics Conference 2007, Université de Bologne.

Background and mandate of Ad Hoc Working Group for Transportation Planning

Contiene los antecedentes del Grupo Especial de Trabajo sobre Planificacion del Transporte y el mandato, acordado por los Ministros en la Quinta Sesion del CDCC, sobre el desarrollo de un programa en el sector transporte, en especial transporte maritimo, en base a recomendaciones hechas en estudios anteriores.

Background and mandate of Ad Hoc Working Group of Planners in Agriculture

Contiene una vision general del proposito de este grupo de trabajo del CDCC en lo que se refiere a las tareas de formular estrategias para el desarrollo del sector agricola en la region.