基于DRGs方法医院感染管理在某院ICU的应用

Application of diagnosis-related groups in the management of healthcare-associated infection in intensive care unit of a hospital

目的探索疾病诊断相关组(DRGs)指标体系在医院感染管理上的应用。方法搜集2018年4—11月某院重症监护病房(ICU)出院患者医院感染信息及DRG分组、病例组合指数(CMI)等DRGs相关指标,通过CMI调整医院感染发病率,比较调整前后ICU医院感染发病率,确定各ICU发生医院感染人数较多的DRG组,有针对性地提出医院感染预防与控制措施。结果CMI调整前,神经外科ICU医院感染发病率最高(38.78%),新生儿ICU医院感染发病率最低(5.14%),经CMI调整后,综合ICU医院感染发病率最高(12.37%),急诊ICU医院感染发病率最低(2.11%)。各ICU发生医院感染出院患者居前三位的DRGs组共14个,占全部DRGs的7.37%;而14个DRGs患者中发生医院感染共198例,占全部医院感染患者的57.89%。结论DRGs指标体系有助于不同类别或医院间感染发病率的比较分析,为医院感染管理提供了新思路。

Objective To explore the application of diagnosis-related groups(DRGs)index system in the management of healthcare-associated infection(HAI).Methods DRGs-related indexes,including HAI information,DRG grouping,and case mixed index(CMI)of discharged patients in the intensive care unit(ICU)of a hospital from April to November 2018 were collected,incidence of HAI was adjusted through CMI,incidence of infection in ICU before and after adjustment was compared,DRGs with more infected patients in each ICU was determined,HAI prevention and control measures were put forward.Results Before CMI adjustment,incidence of HAI was the highest in neurosurgical ICU(38.78%)and lowest in neonatal ICU(5.14%);after CMI adjustment,incidence of HAI was the highest in general ICU(12.37%)and lowest in emergency ICU(2.11%).There were 14 DRGs in the top three of discharged patients with HAI in each ICU,accounting for 7.37%of all DRGs;there were 198 cases of HAI in patients in 14 DRGs,accounting for 57.89%of all HAI patients.Conclusion DRGs index system helps to compare and analyze the incidence of different types of HAI as well as HAI in different hospitals,which provides a new idea for HAI management.