医院获得性败血症对患者住院费用及住院日影响的回顾性研究

A retrospective study on impact of healthcare-associated septicemia on hospitalization expense as well as length of hospital stay

目的 探讨医院获得性败血症对患者住院费用及住院日的影响,为优化医院卫生资源的配置,减少因败血症引起的经济负担提供科学依据。方法 回顾性调查2012年6月1日—2015年5月31日厦门市某三级甲等教学医院确诊医院获得性败血症的住院患者,按照1∶1匹配设立对照组,比较两组间的住院费用与住院日。结果 共纳入病例285例,匹配对照285例。病例组住院费用（中位数）为19 718.39元,高于对照组的住院费用（中位数为9 289.04元）;病例组的住院日数（中位数）为14.89 d,长于对照组的住院日数（9.22 d）,差异均有统计学意义（均P〈0.05）。不同年龄组和科室间因败血症造成的疾病负担存在差别。病例组的好转率为76.49%（218/285）,低于对照组的83.51%（238/285）,两组间差异具有统计学意义（χ^2=2.562,P=0.009）。结论 败血症作为较为常见的血流感染性疾病,不仅增加了诊疗费用,同时影响了医院病床的周转。发展快速有效的诊疗手段,预防和控制败血症意义重大。

Objective To explore the impact of healthcare-associated septicemia （HAS）on hospitalization expense as well as length of hospital stay,so as to optimize the allocation of healthcare resources,and provide scientific basis for reducing the economic burden caused by septicemia.Methods Hospitalized patients with confirmed HAS in a tertiary first-class teaching hospital between June 1 ,2012 and May 31 ,2015 were investigated retrospectively,con-trol group was set up in a 1 ：1 ratio,hospitalization expense and length of hospital stay between two groups were compared.Results A total of 285 cases and 285 controls were enrolled in the study,the median of hospitalization expense in case group was higher than control group （￥19 718.39 vs ￥9 289.04,P 〈0.05）;the median of length of hospital stay in case group was longer than control group （14.89 days vs 9.22 days,P 〈0.05）.The disease bur-den caused by septicemia in different age groups and departments were different.The improvement rate of case group was lower than control group （76.49% [218/285 ]vs 83.51 % [238/285 ],χ^2 = 2.562,P = 0.009 ）. Conclusion As the common blood stream infection in hospitalized patients,septicemia not only increased the ex-pense of diagnosis and treatment,but also affected turnover rate of hospital bed.Rapid and effective diagnosis and treatment is significant o prevent and control septicemia.