老年脑梗死患者下呼吸道医院感染直接经济损失研究

Study on Direct Economic Costs of Nosocomial Infections in Geriatric Cerebral Infarction Patients

目的研究老年急性脑梗死患者发生下呼吸道医院感染的直接经济损失,明确引起经济损失的各项费用来源。方法采用回顾性调查分析的方法,调查2012年1月至2013年6月于老年病科住院的急性脑梗死患者285例,选择下呼吸道医院感染患者和无医院感染患者,根据配对条件配成35对,包括病例组(下呼吸道医院感染组)和对照组(未发生医院感染组),比较两组间各项住院费用的差异。结果病例组医疗费用中位数14 193元,对照组11 913元,两组差异有显著(Z=-5.159,P<0.001);住院费用中,支出费用最多是药品费用,病例组药品费用中位数8801元,对照组6642元(Z=-5.143,P<0.001);病例组较对照组住院日延长,差异有显著性(Z=-5.179,P<0.001)。结论老年脑梗死患者发生下呼吸道医院感染增加了直接经济损失。

Objective To evaluate the direct economic cost of nosocomial infections （NI） in geriatric acute cerebral infarction patients and to indentify the source of direct economic cost. Methods A retrospective study was conducted. Data of 285 acute cerebral infarction inpatients in a geriatric unit from January 2012 to June 2013 were collected. According to the mate conditions, 35 pair of cases （the patients with lower respiratory tract NI was described as case group and the non-NI patients was described as control group） were studied and the cost differences were compared between the two groups. Results The medical costs （medians, 14 193 Yuan） of case group was higher than those of control group （11 913 Yuan）, and there was a signiifcant difference between the two groups （Z=-5.159, P〈0.001）, the highest part of cost was found in medicine expenses, case group 8801 Yuan and control group 6642 Yuan （Z=-5.143, P〈0.001）. The hospitalization days of the patients with NI compared with those non-NI patients were prolonged and the difference came to a statistic signiifcance （Z=-5.179, P〈0.001）. Conclusion Lower respiratory tract NI that developed in geriatric cerebral infarction patients causes a signiifcant increase in direct economic cost.