无菌层流病房应用于预防初治急性髓系白血病患者院内感染的成本效益分析

Cost-benefit Analysis of Aseptic Laminar Flow Ward in Preventing Nosocomial Infection in Patients with Acute Myeloid Leukemia

目的研究无菌层流病房在预防初治急性髓系白血病患者首次诱导化疗期院内感染的成本效益,为无菌层流病房的推广使用提供理论依据。方法选择2016年4月至2019年4月我科收治的初治急性髓系白血病患者100例,50例为观察组,入住无菌层流病房,50例为对照组,入住普通病房。两组患者其他保护性隔离措施相同,观察两组患者院内感染相关指标、感染部位、直接医疗费用、直接非医疗费用、间接经济负担和照顾者费用负担,运用计量经济分析方法,分析患者疾病经济负担以及使用无菌层流病房的效益成本比。结果观察组患者平均住院天数、发热持续时间、抗生素使用时间和院内感染率均低于对照组,两组比较差异有统计学意义(p<0.05);呼吸道感染例次少于对照组(p<0.05),其他部位感染例次与对照组比较差异无统计学差异(p>0.05);观察组患者的疾病经济负担与对照组患者相比降低了2.99万元,差异具有统计学意义(p<0.01),使用无菌层流病房可获得1.50的效益成本比。结论初治急性髓系白血病患者首次诱导化疗期入住无菌层流病房,不仅可以降低院内感染率,而且可以减轻患者疾病经济负担。

Objective To study the cost-effectiveness of sterile laminar flow wards in preventing nosocomial infection during the first induction chemotherapy in patients with acute myeloid leukemia(AML),so as to provide theoretical basis for the popularization of aseptic laminar flow wards.Methods A total of 100 patients with first treated AML admitted to our department from April 2016 to April 2019 were selected.Fifty cases were in the observation group and were admitted to a sterile laminar flow ward,and 50 cases were in the control group and admitted to a general ward.The protective isolation measures of the two groups were the same.The patients of the two groups were observed for nosocomial infection indicators,infection sites,direct medical expenses,direct non-medical expenses,indirect financial burden and caregiver costs.Econometric analysis methods were used to analyze the patients'economic disease burden and the cost-effectiveness ratio of sterile laminar flow ward.Results The average length of stay,fever duration,antibiotic use time and nosocomial infection rate of the observation group were lower than those of the control group,and the differences were statistically significant(p<0.05);the number of respiratory tract infection cases of the observation group was smaller than the control group(p<0.05).There was no statistically significant difference in the number of infections in other body parts between the two group(p>0.05).The economic disease burden in the observation group was 29,900 yuan lower than the control group(p<0.01).The cost-effectiveness ratio of sterile laminar flow ward was 1.50.Conclusion Admitting AML patients to the sterile laminar flow ward during the first induction chemotherapy can not only reduce the nosocomial infection rate,but also reduce the economic disease burden.