肝衰竭医院感染直接经济损失研究

Direct economic cost of liver failure-related healthcare-associated infection

目的探讨肝衰竭患者发生医院感染所导致的直接经济损失,使决策者和医务工作者对医院感染的危害有直观的认识。方法收集贵州省某三级甲等综合医院感染内科2009年12月-2014年12月肝衰竭患者,根据1∶1比例配对,病例组为合并医院感染患者,对照组为同期未发生医院感染的患者,采用配对秩和检验比较住院时间和医疗费用,应用SPSS 17.0统计软件进行分析。结果收集肝衰竭患者276例,有效配对23例。结果显示肝衰竭医院感染患者平均住院时间较非医院感染患者延长11 d(P=0.01),平均医疗费用多支出22 980.01元(P=0.01)。分析各项费用组成,病例组前三位由高至低依次为药费(40.25%)、材料费(20.32%)、输血费(13.90%)。对照组前三位由高至低依次为药费(60.13%)、化验费(14.57%)、输血费(7.25%)。结论肝衰竭医院感染患者较未发生医院感染患者平均住院时间延长,平均医疗费用多支出较高,加重了患者的经济负担。

Objective To explore the direct economic loss due to healthcare-associated infection(HAI)in patients with liver failure,so as to make policy makers and health care workers have an intuitive understanding of the harm of HAI.Methods Patients with liver failure in a tertiary first-class general hospital in Guizhou Province from December 2009 to December 2014 were analyzed,according to 1∶1 ratio,patients with HAI were in case group,while those without HAI during the same period were in control group,length of hospital stay and medical cost were compared by paired rank sum test,SPSS 17.0 software was used to perform statistical analysis.Results 276 cases of liver failure were collected,23 of which were matched effectively.The results showed that the average length of hospital stay of liver failure patients complicated with HAI was 11 days longer than that of patients without HAI(P=0.01),and the average medical cost were 22 980.01 yuan more(P=0.01).The top three cost in case group from high to low were medicine(40.25%),material(20.32%)and blood transfusion(13.90%),in control group were medicine(60.13%),laboratory detection(14.57%)and blood transfusion(7.25%).Conclusion The average length of hospital stay of liver failure patients complicated with HAI is longer than that of patients without HAI,and the average medical cost is higher,which increases the economic burden of patients.