基于DRGs的医院感染疾病负担研究

Burden of nosocomial infection analysis based on DRGs

目的:基于诊断相关分组(DRGs)比较分析医院感染病例的疾病负担情况。方法:回顾性分析2016年北京市某三甲医院全部出院病例的DRGs信息及该医院2016年全部医院感染病例基本信息。以2016年北京地区全市DRGs分析情况作为标杆数据,比较医院感染病例与非医院感染病例的时间消耗指数及费用消耗指数,分析医院感染病例的疾病负担情况。结果:2016年,该院DRGs入组病例共计49 818例,其中院感病例930例,主要分布于神经系统疾病及功能障碍(MDCB)、呼吸系统疾病及功能障碍(MDCE)、循环系统疾病及功能障碍(MDCF)3个主要诊断类别组中。以上三组中,医院感染病例组的时间消耗指数分别为1.43、1.38及1.82,均高于非院感病例组,其中循环系统疾病中院感病例组的时间消耗指数为非院感组的1.84倍,差异最为显著;医院感染病例组的费用消耗指数分别为2.02、1.99及1.84,明显高于非院感病例组,其中神经系统疾病院感病例组的费用消耗指数为非院感病例组的2.15倍,差异显著。结论:医院感染显著增加患者的疾病负担,降低了医院整体的医疗效率及服务评价。

Objectives:To compare and analyze the burden of nosocomial infection cases based on the Diagnosis Related Groups(DRGs).Methods:DRGs’information and nosocomial infection information of all hospitalized cases from a top tertiary hospital in Beijing in 2016 were retrospectively collected.Taking Beijing DRGs analysis results as benchmark,the time consumption index and cost consumption index were compared between nosocomial infection cases and non-nosocomial infection cases to measure disease burden of nosocomial infection.Results:In 2016,the cases into the DRGs is 49818,including 930 nosocomial infection cases,mainly distributed in nervous system diseases and disorders(MDC-B),respiratory system diseases and disorders(MDC-E)and circulatory system diseases and disorders(MDC-F).Above these three groups,the time consumption index were 1.43,1.38 and 1.43 respectively,significantly higher than the group of non-infection cases and the highest multiple is 1.84 in MDC-F.The cost consumption index of these three diseases is 2.02,1.99 and 1.84 respectively,higher than the group of noninfection cases too,and the highest multiple is 2.15 in MDC-B.Conclusions:Nosocomial infection has significantly increased the burden of disease and reduced the medical efficiency and service evaluation of the hospital.