食管癌手术患者医院感染直接经济损失分析

Direct economic loss due to healthcare-associated infection in patients undergoing esophageal cancer surgery

目的分析食管癌患者术后发生医院感染情况及其造成的直接经济损失,为医院感染防控提供依据。方法采用1∶1病例对照研究方法回顾性分析某院2018年1月—2019年12月食管癌手术患者,术后发生医院感染者为病例组,术后未发生感染者为对照组,比较两组患者住院时间和医疗费用的差异。结果病例组患者住院日数中位数为37.0 d,对照组为16.0 d,因感染导致住院日数增加21.0 d,差异有统计学意义(P<0.001)。病例组患者住院总费用中位数为131170.3元,对照组为90455.6元,因感染导致直接经济损失40714.7元,差异有统计学意义(P<0.001)。多部位感染患者住院日数、住院费用均高于单部位感染患者,差异有统计学意义(均P<0.05),其中肺部合并血流感染患者的住院日数、住院费用均高于对照组。结论食管癌患者术后发生医院感染明显延长其住院时间,增加住院费用,不同感染部位对患者的直接经济损失影响有一定差别,应针对重点环节加强食管癌手术患者医院感染的防控工作。

Objective To analyze the occurrence and direct economic loss of post-operative healthcare-associated infection(HAI)in patients undergoing esophageal cancer surgery,and provide basis for the prevention and control of HAI.Methods A 1∶1 case-control study was used to retrospectively analyze patients undergoing esophageal cancer surgery in a hospital from January 2018 to December 2019,patients with post-operative HAI were in case group,those without post-operative infection were in control group,hospitalization time and medical expense of two groups of patients were compared.Results The median hospitalization time of case group and control group were 37.0 days and 16.0 days respectively,the increased hospitalization time due to HAI was 21.0 days,difference was statistically significant(P<0.001).The median total hospitalization expense of case group and control group were 131170.3 Yuan and 90455.6 Yuan respectively,direct economic loss due to infection was 40714.7 Yuan,diffe-rence was statistically significant(P<0.001).Hospitalization days and expense in patients with multiple site infection were higher than those with single site infection,difference was statistically significant(both P<0.05),patients with pulmonary infection and bloodstream infection had longer hospitalization days and higher hospitalization expense than control group.Conclusion Post-operative HAI in esophageal cancer patients can significantly prolong the length of hospital stay and increase the expense of hospitalization,the impact of different infection sites on the direct economic loss of patients is different,prevention and control of HAI in patients undergoing esophageal cancer surgery should be strengthened.