肾移植手术患者下呼吸道医院感染经济损失

Economic losses caused by healthcare-associated lower respiratory tract infection in kidney transplant patients

目的了解肾移植手术患者发生下呼吸道感染的经济损失。方法调查某三级甲等医院2008—2012年所有进行肾移植手术的患者,将发生医院下呼吸道感染的45例患者设为感染组,同期未发生医院感染的266例患者设为对照组,比较两组患者住院费用和住院天数的差异。结果纳入研究的患者共383例,其中下呼吸道医院感染发生率为11.75%(45例)。感染组的住院费用中位数为79 291.82元,对照组为72 185.14元,两组差异无统计学意义(P>0.05)。感染组患者住院费用增加最多的是西药费(增加5 429.82元),其西药费(39 123.17元)和检查费(702.52元)与对照组(分别为33 693.35元和593.73元)比较,差异有统计学意义(均P<0.05)。感染组患者住院天数中位数为28.38 d,对照组为21.47 d,两组比较,差异有统计学意义(P<0.05)。结论肾移植术后患者发生下呼吸道感染会加重经济负担,延长住院时间,应采取措施防止肾移植术后患者发生下呼吸道感染,节约有限的医疗资源。

Objective To investigate the economic losses in kidney transplant patients with healthcare-associated lower respiratory tract infection（LRTI）.Methods All transplant patients in a hospital from 2008 to 2012 were in-vestigated,patients with LRTI were in infection group（n=45）,and patients without LRTI were in control group（n=266）,hospitalization expenses and hospitalization days between two groups were compared.Results A total of 383 kidney transplant patients were included in the study,the incidence of LRTI was 11 .75% （n=45）,median ex-pense of infection group and control group was ￥79 291 .82 and ￥72 185.14 respectively,the difference was not statistically significant （P 〉0.05）.The largest increased expense in patients with LRTI was medicine （increased by￥5 429.82）,medicine and examination expense in infection group were significantly higher than control group （￥39 123.17 vs ￥33 693.35;￥702.52 vs ￥593.73;P 〈0.05 ）.The median hospitalization days in infection group and control group was 28.38 days and 21 .47 days respectively,there was significant difference between two groups（P 〈0.05 ）.Conclusion Kidney transplant patients with LRTI suffer from a heavy financial burden,and their hospitalization days are prolonged,so measures should be taken to prevent the occurrence of LRTI and save limited medical resources.