神经外科清洁手术患者医院感染的经济损失

Economic loss due to healthcareassociated infection in patients undergoing clean neurosurgical operation

摘要:

目的分析神经外科清洁手术患者发生医院感染所造成的额外住院费用、住院时间，评估医院感染导致的经济损失。方法收集2014年1月—2016年12月某院神经外科清洁手术患者的临床资料，采取年龄频数匹配的病例对照方法，将发生单部位医院感染的151例患者作为病例组，从同期未发生医院感染的同年龄段患者中随机抽取151例患者作为对照组，比较两组患者的各项住院费用、住院时间，计算医院感染导致的经济损失费用。结果共收治患者801例，发生医院感染194例、245例次，医院感染发病率为24.22%，医院感染例次发病率为30.59%，其中发生单部位医院感染151例，单部位医院感染发病率为18.85%。在单部位感染中，发生呼吸系统感染患者的住院费用最高，发生泌尿系统感染患者的住院时间最长。病例组和对照组的总住院费用中位数分别为110 181、60 398元，差异有统计学意义（P＜0.05）；两组住院日数中位数分别为30、18 d，差异有统计学意义（P＜0.05）；人均医院感染经济损失为52 661.64元。结论神经外科清洁手术患者发生医院感染造成的经济损失巨大，做好医院感染的防控，对于降低医院感染带来的经济损失具有重要意义。

关键词:

神经外科; 清洁手术; 医院感染; 经济损失

Abstract:

ObjectiveTo analyze the extra hospitalization expense and length of hospital stay due to healthcareassociated infection(HAI) in patients undergoing clean neurosurgical operation, and evaluate the economic loss caused by HAI.MethodsClinical data of patients who underwent clean operation in a neurosurgical department from January 2014 to December 2016 were collected, according to age frequencymatched case control method, 151 patients with single site HAI was as case group, 151 patients without HAI were randomly selected from the same age group and as a control group, hospitalization expense and length of hospital stay were compared between two groups of patients, economic loss caused by HAI was calculated.ResultsA total of 801 patients underwent clean neurosurgical operation, 194 patients had 245 cases of HAI, HAI rate and HAI case rate were 24.22% and 30.59% respectively，151 (18.85%) cases were single site HAI. Among patients with single site infection, hospitalization expense in patients with respiratory system infection was the highest, length of hospitalization in patients with urinary tract infection was the longest. The median of total hospitalization expense in case group and control group were 110 181 and 60 398 yuan respectively, difference was statistically significant（P＜0.05）；the median length of hospital stay in two groups were 30 days and 18 days respectively, difference was statistically significant (P<0.05); the average economic loss due to HAI was 52 661.64 yuan.ConclusionThere is huge economic loss due to HAI in patients undergoing clean neurosurgical operation, prevention and control of HAI is very important for reducing the economic loss caused by HAI.

Key words:

neurosurgery; clean surgery; healthcareassociated infection; economic loss