摘要
目的通过分析医院感染的直接经济负担,为探索DRG付费制度下医院感染防控的价值和制定有效措施提供依据。方法回顾性分析北京市某三甲医院2022年4月1日—2024年4月30日住院患者医院感染病例情况,纳入研究的出院病例共71911例,其中医院感染病例802例,非医院感染病例71109例。比较相同DRG组内医院感染病例与非医院感染病例的住院时间及住院费用。使用SPSS 22.0软件对数据进行统计学分析。采用Mann-Whitney U检验,比较医院感染患者与非感染患者在平均住院日、住院费用上的差异。结果医院感染的802例中,大于20例的DRG组有:AH11组3.87%(31/802)、BR23组3.62%(29/802)、EQY组3.37%(27/802)、ES31组3.12%(25/802)、FM19组3.12%(25/802)、RB21组2.49%(20/802)和BR13组2.49%(20/802)。外科手术操作组的医院感染患者最多为394例,占49.13%;其次为内科诊断组269例,占33.54%;非手术室操作组139例,占17.33%。各组医院感染患者的平均住院日及住院费用均明显高于无医院感染组,P<0.05,差异具有统计学意义。呼吸系统发生感染率最高455例,占56.73%;其次为泌尿系统感染72例,占8.98%;中枢神经系统发生感染率最低为7例,占0.87%。结论住院患者发生医院感染将显著增加患者的住院费用和住院时长,做好医院感染预防与控制,控制血液系统感染和手术部位感染是降低医院感染住院费用和住院时长的重点。
Objectives To investigate the economic burden of hospital-acquired infections(HAIs)based on Diagnosis-Related Groups(DRG),and explore the application of DRG payment system in HAIs management.Methods We retrospectively analyze the hospitalization days and hospitalization expenditure for HAIs in patient records from the Three A and Tertiary Hospital in Beijing from April 1st,2022 to April 30th,2024.A total of 71,911 discharge cases were included,of which 802 were HAIs cases and 71,109 were non-HAIs cases,comparing cases to appropriate non-HAIs controls.Statistical analysis was performed using SPSS 22.0 software.The Mann-Whitney U test was employed to compare differences in average hospital stay and hospitalization costs between patients with and without hospital infections.Results Among the 802 cases of hospital infection,the DRG group with more than 20 cases included:Group AH113.87%(31/802),Group BR233.62%(29/802),Group EQY 3.37%(27/802),Group ES313.12%(25/802),Group FM193.12%(25/802),Group RB212.49%(20/802),and Group BR132.49%(20/802).The surgical operation group had the largest number of nosocomial infection patients,with 394 cases,accounting for 49.13%.Secondly,there were 269 cases in the internal medicine diagnosis group,accounting for 33.54%.Finally,there were 139 cases in the non-operating room operation group,accounting for 17.33%.The average length of hospitalization days and hospitalization expenses of patients with nosocomial infections in each group were significantly higher than those in the non-nosocomial infection group,P<0.05,and the difference was statistically significant.The respiratory system had the highest infection rate of 455 cases,accounting for 56.73%.Secondly,there were 72 cases of urinary system infections,accounting for 8.98%.The infection rate of the central nervous system was the lowest,with 7 cases,accounting for 0.87%.Conclusions Patients with HAIs incurred greater hospitalization expenditure and hospitalization days.It was important to give attention to the prevention and control of HAIs under the DRG-based reimbursement.In order to reduce hospitalization expenses and hospitalization days of HIAs,it was crucial to control bloodstream infections and surgical site infections.
作者
李顺丽
王丽
赵静
张颖
梅雪
Li Shunli;Wang Li;Zhao Jing;Zhang Ying;Mei Xue(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100o20,China;不详)
出处
《中国病案》
2025年第12期56-59,共4页
Chinese Medical Record
关键词
疾病诊断相关分组
医院感染
经济负担
住院费用
Diagnosis-Related Groups(DRG)
Hospital-acquired infections
Economic burden
Hospitalization expense
