87例手术部位感染对经济损失及住院日影响的病例对照研究

The Case-control Study of the Influence of Surgical Site Infection on Economic Losses and the Hospitalization Days(87 Cases Report)

目的从统计经济学角度探讨手术部位感染对住院日及经济损失的影响。方法采用1∶1配对方法对出院病历进行回顾性病例对照研究,比较手术部位感染病例87例(病例组)与同期类似未发生手术部位感染的病例(对照组)的住院日及住院费用。结果病例组住院费用的中位数是45 678元,对照组是24 183元,感染组是对照组的1.89倍,两组比较有显著性差异(P=0.0000),手术部位感染直接额外费用9 134元;感染组住院日的中位数是25 d,对照组是15 d,手术部位感染延长住院天数中位数是12 d,两组比较有显著性差异(P=0.0000);术前住院日与手术部位感染无相关性,手术部位感染主要是延长术后住院日(P=0.0000)。结论手术部位感染的直接经济损失十分可观,由于住院日延长所造成的间接经济损失也不能忽视,不同部位手术的手术部位感染所造成的住院天数延长及经济损失各不相同,有效的监控计划可以减轻患者经济负担。

Objective To discuss the influence of surgical site infection （SSI） on the length of stay and economic loss from the perspective of statistics and economics. Methods The 1 ： 1 matching methods were used for retrospective case-control study of hospital medical records, comparing hospital stay and hospital charge in 87 cases involving SSI （infection group） and 87 cases who did not involve SSI （control group）. Results The median of hospital charge of the infection group and the control group was 45 678 Yuan and 24 183 Yuan re- spectively. The infection group was 1.89 times more than the control group. The direct extra hospital charge of SSI was 9 134 Yuan. There was a significant difference between the two groups （P =0.0000）. The medians of the hospital of stay of the infection group and the control group was 25 days and 15 days respectively. The median of extending hospitalization was 12 days. There was a significant difference between the two groups （P =0.0000）. There was no correlation between preoperative hospital stay and SSI. SSI mainly extended the postoperative length of stay. Conclusion The direct economic loss of SSI is significant. Also, the indirect economic loss is caused by the extended hospitalization. In addition, the SSI at different positions lead to different extended hospitalization days and the economic loss. Effective monitoring plan may reduce the economic burden of the patients.