恶性肿瘤住院患儿医院感染现状与直接经济损失分析

Current status of nosocomial infections in hospitalized children with malignant tumor and direct economic loss

目的分析恶性肿瘤住院患儿医院感染现状与直接经济损失。方法选取2013年1月1日-2014年12月31日江苏省某三级甲等医院收治的恶性肿瘤患儿为调查对象,在调查感染现状的基础上,通过病例对照研究,分析恶性肿瘤患儿医院感染相关直接经济损失。结果共717例患儿纳入分析,其中107例患儿住院期间发生过1次及以上医院感染,共发生医院感染125例次,感染例次率为17.43%;血液肿瘤与实体肿瘤感染组患儿医院感染部位构成比较差异具有统计学意义(χ~2=27.154,P=0.007);血液肿瘤感染组患儿住院总费用中位数为50108.80元,住院天数为(26.32±14.08)d;非感染组住院总费用中位数为20424.71元,住院天数为(15.89±9.13)d;实体肿瘤感染组患儿住院总费用中位数为18972.75元,住院天数为(21.36±9.00)d;非感染组住院总费用中位数为8985.46元,住院天数为(15.43±7.38)d。感染组住院费用与住院天数和对照组比较差异均具有统计学意义(P<0.05)。结论恶性肿瘤患儿医院感染发生率处于较高水平,血液肿瘤患儿感染风险高于实体肿瘤患儿,两者常见医院感染部位存在差异。医院感染导致恶性肿瘤患儿住院费用增高,住院天数延长,直接经济损失较严重。

OBJECTIVE To investigate the current status of nosocomial infections in hospitalized children with malignant tumor and analyze the direct economic loss.METHODS The children with malignant tumor who were treated in a three-A hospital of Jiangsu province from Jan 1,2013 to Dec 31,2014 were recruited as the study objects.On the basis of the survey of prevalence of infections,a case-control study was conducted to analyze the direct economic loss due to the nosocomial infections.RESULTS Of totally 717 children who were enrolled in the study,107 had nosocomial infections for more than 1 time during the hospital stay,125 case-times of patients had nosocomial infections,with the case-time infection rate 17.43%.There were significant differences in the constituent ratios of nosocomial infection sites between the hematologic tumor infection group and the solid tumor infection group（χ2=7.154,P=0.007）.The median of total hospitalization cost of the hematologic tumor infection group was 50108.80 yuan,the hospitalization duration was（6.32±14.08）days;the median of the total hospitalization cost of the non-infection group was 20424.71 yuan,the hospitalization duration was（15.89±9.13）days.The median of the total hospitalization cost of the solid tumor infection group was 18972.75 yuan,the hospitalization duration was（21.36±9.00）days;the median of total hospitalization cost of the non-infection group was 8985.46 yuan,the hospitalization duration was（15.43±7.38）days;there were significant differences in the hospitalization cost and hospitalization duration between the infection group and the control group（P〈0.05）.CONCLUSIONThe incidence of nosocomial infection is high in the children with malignant tumor.The children with hematologic tumor are at higher risk of infections than the children with solid tumor,and there are significant differences in the nosocomial infection sites between the two.The nosocomial infection may lead to the increase of hospitalization cost and extension of hospitalization duration,with the direct economic loss great.