外科手术部位感染致直接经济损失1∶1匹配病例对照研究

1∶1 matched case-control study on direct economic loss of surgical site infection

目的研究住院患者因手术部位感染所造成的直接经济损失,为卫生政策研究提供参考依据。方法回顾性抽取二级医疗机构2015年度行外科手术病例,进行1∶1条件匹配,发生手术部位感染为SSI组,同期手术未发生感染患者为对照组,共匹配42对,比较两组住院日和住院费用差异。结果 SSI组住院总费用(中位数)为26 514.0元,对照组为17 316.0元,两组比较,差异有统计学意义(P<0.05);每例SSI患者的额外经济损失(中位数)为8 095.5元;SSI组住院日(中位数)为22.5日,对照组11.0日,两组比较差异有统计学意义(P<0.05)。每例SSI患者的额外住院日数(中位数)为11.5日;不同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。结论 SSI导致严重的经济负担,因此有效的预防控制SSI可减少患者经济损失,增加医院收入,减轻卫生系统负担。

OBJECTIVE To evaluate the direct economic loss due to surgical site infection（SSI）in hospitalized patients,so as to references for health policy.METHODS Surgical cases of secondary medical institutions in2015 were retrospectively selected,and 1∶1conditional matching method was carried out.The patients with surgical site infection were set as SSI group,while the patients without infection during operation were set as control group,and 42 pairs were matched.The hospital stay and hospital charge of the two groups were compared.RESULTS The median of hospital charge of SSI group and control group were respectively 26514.0Yuan and17316.0Yuan.There was a significant difference between the two groups（P〈0.05）.The median of direct extra hospital charge of each SSI patient was 8095.5Yuan.The median of the hospital of stay of SSI group and control group were respectively 22.5days and 11.0days.There was a significant difference between the two groups（P〈0.05）.The median of extra hospitalization day was 11.5days.The SSI at different sites led to different extra hospitalization days and economic loss.CONCLUSIONSSI causes significant clinical and economic burden.So,effective prevention and control of SSI can reduce the economic loss of patients,increase the hospital income,and reduce the burden of the health system.