江苏省三级综合医院呼吸机相关肺炎防控成本效益多中心研究

A multi-center study on cost-effectiveness of prevention and control of ventilator-associated pneumonia in tertiary comprehensive hospitals in Jiangsu Province

目的探讨呼吸机相关肺炎(VAP)医院感染防控的成本效益。方法选取江苏省12所医院,采取多中心1∶1匹配的病例对照研究,并通过荟萃分析进行率差计算。结果共有255对病例和对照进入本次研究。研究发现发生1例VAP患者,需多支出103 799.00元,多在ICU住11.72 d,多住院15.53 d。在考虑了不同年份物价指数的基础上,2015年比2014年为患者节省了0.36亿元。ICU每控制好1例感染,可以多收治0.76例新患者。2015年医院收益为24 464 560.5元,医院和患者直接经济总收益为60 883 996.6元。结论医院感染防控为医疗本体内涵之一,做好感染防控,能极大地降低患者疾病负担,节省经济成本,为医院创造效益,并能提升医院形象,从而可以实现"患者—医院—社会"的三赢。

Objective To explore the cost-effectiveness of infection prevention and control of ventilator-associated pneumonia(VAP).Methods 12 hospitals in Jiangsu Province were chosen,a 1∶1 matched case-control multi-center study was adopted.The rate difference was calculated by Meta analysis.Results A total of 255 cases and controls were enrolled in this study.The study found that each VAP patient had to spend additional 103 799.00 yuan,stay in ICU for extra 11.72 days,and in hospital for extra 15.53 days.On the basis of the price index of different years,compared with 2014,2015 saved 36 million yuan for patients.Prevention of one case of VAP in ICU could treat 0.76 more new patients.The hospital revenue was 24 464 560.5 yuan in 2015.The total direct economic benefits of hospitals and patients were 60 883 996.6 yuan.Conclusion Prevention and control of HAI is one of the medical ontology connotation,it can greatly reduce the economic burden of patients,save economic cost,create bene-fits and enhance the image for hospital,and achieve a triple win situation for"patients-hospital-society".