多重耐药鲍曼不动杆菌医院感染的直接经济损失研究

Direct economic loss due to healthcare-associated infection with multidrugresistant Acinetobacter baumannii

目的了解多重耐药鲍曼不动杆菌(MDR-AB)医院感染的直接经济损失。方法选取重庆市某三级甲等综合医院2014年9月—2016年8月住院患者中发生MDR-AB医院感染的65例住院患者(设为病例组),采用1∶1配对病例对照研究方法,按配对条件选取同期未发生医院感染的住院患者65例(设为对照组),分析比较MDR-AB医院感染的直接经济损失。结果病例组住院总费用、药占比、住院日数中位数分别为167 579.56元、37.40%、52 d;对照组则为59 386.77元、31.85%、27 d,MDR-AB医院感染所导致的平均直接经济损失为108 192.79元,主要为药费、护理费、治疗费、检验费,其中药费所占比例最高;MDR-AB医院感染延长的平均住院日数为25 d;病例组各分类费用高于对照组,差异均有统计学意义(均P<0.05)。结论 MDR-AB医院感染所导致的经济损失严重,增加药占比,延长住院时间,应重视其预防与控制。

Objective To understand direct economic loss due to healthcareassociated infection（HAI） with multidrugresistant Acinetobacter baumannii（MDRAB）. Methods65 hospitalized patients with MDRAB in a tertiary firstclass general hospital in Chongqing City between September 2014 and August 2016 were as case group, a 1∶1 matched casecontrol study was adopted, 65 hospitalized patients without HAI during the same period were selected as control group, direct economic loss due to MDRAB HAI was analyzed and compared. ResultsThe median of hospitalization expense, medicine proportion, and length of hospital stay in case group were 167 579.56 yuan, 37.40%, and 52 days respectively, while those in control group were 59 386.77 yuan, 31.85%, and 27 days respectively, the average direct economic loss due to MDRAB HAI was 108 192.79 yuan, mainly for fees of medicine, nursing, treatment, and laboratory detection, the proportion of medicine was the highest; the average extension of length of hospital stay due to MDRAB HAI was 25 days; each expense in case group was higher than that of control group, difference were all statistically significant （all P〈0.05）. ConclusionEconomic loss due to MDRAB HAI is serious, proportion of medicine is increased, and length of hospital stay is prolonged, prevention and control should be paid attention.