内蒙古自治区某三级医院住院患者常见医院感染的直接经济损失

Direct economic loss due to healthcare-associated infection in hospitalized patients in a tertiary hospital in Inner Mongolia Autonomous Region

摘要:

目的 对住院患者常见医院感染造成的直接经济损失进行研究，为增强医务人员医院感染防控意识，提升医院感染防控能力提供参考依据。方法 回顾性调查2017年1月1日-12月31日内蒙古自治区某三级医院发生呼吸道医院感染、血流医院感染、消化道医院感染、手术部位感染、泌尿道医院感染的住院患者，按照配对标准1：1配对病例组（医院感染）和对照组（非医院感染），采用配对资料Wilcoxon检验分析医院感染造成的直接经济损失。结果 最终匹配成功262对，每例患者由医院感染所造成的直接经济损失为31 300元，其中重症监护病房（ICU）医院感染直接经济损失最大（100 857元）。两组患者住院总费用、住院日数比较，差异均有统计学意义（均P<0.05）；两组患者床位费、护理费、西药费、手术费、治疗费、化验费、检查费比较，差异均有统计学意义（均P<0.05），各项费用中以西药费最高（14 378元）。两组患者不同医院感染部位造成的平均住院总费用和住院日数比较，差异均有统计学意义（均P<0.05）。不同医院感染部位的平均住院总费用由高至低依次为手术部位（47 469元）、血液（42 498元）、泌尿道（34 598元）、消化道（33 296元）、呼吸道（31 058元）。病例组患者延长平均住院日数7 d，两组患者平均住院日数比较，差异有统计学意义（P<0.05）。结论 住院患者发生医院感染后可导致医疗费用增加，平均住院日延长，给患者带来了较大损失。

Abstract:

Objective To study the direct economic loss due to healthcare-associated infection (HAI) in hospita-lized patients, enhance health care workers' awareness on prevention and control of HAI, and improve the ability of prevention and control of HAI. Methods A retrospective survey was conducted on hospitalized patients with respira-tory tract HAI, bloodstream HAI, gastrointestinal tract HAI, surgical site infection and urinary tract HAI in a tertiary hospital of Inner Mongolia Autonomous Region from January 1 to December 31, 2017, case group (HAI) and control group (non-HAI) were 1:1 mached according to maching standard, Wilcoxon test was used to analyze the direct economic loss caused by HAI. Results 262 pairs of patients were matched successfully, direct economic loss due to HAI of each patient was 31 300 Yuan, and the highest direct economic loss was 100 857 Yuan in intensive care unit. Difference in total hospitalization expense, length of hospital stay between two groups of patients were both statistically significant (both P<0.05); differences in bed fee, nursing fee, western medicine fee, operation fee, treatment fee, laboratory test fee and examination fee between two groups of patients were all statistically significant (all P<0.05), the highest expense was western medicine (14 378 Yuan). Difference in average overall expense and length of hospital stay between two groups of patients of patients were both statistically significant (both P<0.05). The average overall expense of hospitalization in different HAI sites from high to low were as follows:surgical site (47 469 Yuan), bloodstream (42 498 Yuan), urinary tract (34 598 Yuan), gastrointestinal tract (33 296 Yuan), and respiratory tract (31 058 Yuan). The average length of hospital stay of patients in case group extended by 7 days,difference in average length of hospital stay between two groups of patients was statistically significant (P<0.05). Conclusion HAI can lead to the increase of medical expense and prolongation of average length of hospital stay, and bring about greater loss to patients.