单病种付费患者术后切口感染经济损失的病例对照研究

A case-control study of pecuniary loss caused by postoperative infection of patients with single disease category payment

目的通过分析单病种付费中发生切口感染的患者的经济损失及疾病费用承担情况,探讨单病种支付方式对医院感染产生的影响,为医疗保险政策的制定及医院感染管理者提供一定的理论支持。方法以某三甲医院新农合单病种付费患者为例,通过回顾性调查,对单病种付费患者中发生切口感染的患者进行病例对照研究。比较感染组与对照组的住院费用支出和医疗保险报销费用。结果感染组与对照组比较,住院日的延长具有统计学意义(P <0.05),医院承担费用明显高于对照组,具有统计学意义(P<0.05)。住院总费用、药品费用、检查费用、实际报销费用无统计学意义(P>0.05)。结论单病种付费制度可以调动医院防治院内感染的积极性,政府应加强相关配套政策的制定。

Objective By analyzing the pecuniary loss and disease cost bearing of patients suffering incision infection under the payment of single disease category,the paper discusses the impacts of payment of single disease category on nosocomial infection,for the purpose of providing theoretical supports for nosocomial infection managers and the formulation of medical insurance policy.Methods Retrospective case-control study was conducted to discuss patients of postoperative infection of incision under the payment of single disease category in a three A general hospital.Hospitalization expenses and medical insurance reimbursement expenses between the infection group and the control group were compared.Results Compared with control group,the infection group has much longer duration,the difference was statistically significant(P < 0.05).The result showed that cost assumed by hospital of infection group was obviously higher than control group(P < 0.05).The expenses of hospitalization,the medical insurance reimbursement expenses and the cost of medicine,examination has no statistical significance between the two groups(P>0.05).Conclusions The system of payment of single disease category can stimulate the hospital ’s initiative to control hospital infection,and in view of this the government should strengthen the development of related supporting policy.