Valerie Bertrand

Hospital Jacques Monod, France

Title: Systematic nutritional evaluation increases financing of hospital care in children


Valerie Bertrand has completed his PhD at the age of 25 years from Caen University and postdoctoral studies from Lyon University School of Medicine. She works in Le Havre Hospital as gastro-pediatrician.


Children’s malnutrition screening is not systematic in many hospitals. The aim of our study was to screen all children in our center, describe their nutritional status, and calculate the financial valuation of the malnutrition's coding, according pricing activity (T2A). We did a cross-sectional study during 3 months in 3 pediatric units. A child was undernourished when weight/theoretical weight for height was <90% and was overweight when the body mass index z-score> +2 SD (Sempé/Rolland-Cachera graphs). The amount of coding's financial valuation was calculated according the CIM-10 classification. Statistic analysis was done with the IBM-SPSS version 20.0 software (Student’s t test corrected, ANOVA, χ2 test). Among 738 children were hospitalized, 8.4% were undernourished, 7.2% were overweight, and 84.4% had good nutritional status. More than 80% had no previous nutritional care. Overweight children were older (9,9 ±5,2 years) than undernourished children (5,9 ± 5,1 years) or children with good nutritional status (5,9 ± 5,6 years) (p<0.001). Longer hospital stays were observed in undernourished children (4,6 ± 3 years) or overweight children (3,6 ±2,4 years), than children with good nutritional status (3,2 ± 2,8 years) (p<0.001). Undernourished children had more chronic diseases than the others (p<0.001). The amount of malnutrition coding’s financial valuation was positive (+34%). In conclusion, our study shows it’s possible to associate a nutritional screening to hospital’s care project. The observed frequency of malnutrition was in the lower range of data available in the literature. Our initiative helps improve the care of hospitalized children.

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