2019-2021年四川省某三甲中医院住院患者医院感染所致直接经济负担

Direct economic burden due to nosocomial infection in a tertiary hospital of Traditional Chinese Medicine in Sichuan Province from 2019 to 2021

目的 探讨四川省某三甲中医院医院感染所致直接经济负担。方法 回顾性收集四川省某三甲中医院2019年1月-2021年12月住院患者全部信息,将所有非医院感染住院患者作为对照组,根据纳入排除标准清洗数据后就医院感染组住院患者与对照组住院患者进行倾向值评分匹配,匹配结果进行Fisher-Pitman置换检验,分析该中医院医院感染对住院患者抗菌药物费用、住院日数以及住院费用的影响。结果 该三甲中医院3年医院感染患病率为0.49%(883/179 439),经倾向值评分匹配后,医院感染组抗菌药物费用较对照组平均多支出4 927.76元(P<0.001),增加费用为对照组的2.39倍;医院感染组住院日数比对照组平均延长18.00日(P<0.001),增加日数为对照组的1.00倍;医院感染组住院费用比对照组平均多支出38 377.99元(P<0.001),增加费用为对照组的1.32倍。结论 倾向值评分匹配增加了医院感染组与对照组的直接经济负担组间可比性,中医院的医院感染大幅增加住院患者的住院日数、抗菌药物费用以及住院费用。中医院除积极落实中医特色诊疗相关感控措施以降低感染风险外,应该切实发挥中药特色,降低中医院医院感染抗菌药物费用负担。

OBJECTIVE To explore the direct economic burden due to nosocomial infection in a tertiary hospital of traditional Chinese medicine in Sichuan province.METHODS All the information of inpatients admitted to a tertiary hospital of traditional Chinese medicine in Sichuan Province from Jan.2019 to Dec.2021 was retrospectively collected,and all hospitalized patients with non-nosocomial infection were taken as the control group.After cleaning the data according to the inclusion and exclusion criteria,the propensity score matching was performed between the inpatients in the nosocomial infection group and inpatients in the control group.Fisher-Pitman permutation test was performed on the matching results to analyze the impact of nosocomial infection on the cost of antibiotics,hospitalization days and hospitalization expenses of inpatients in the hospital.RESULTS The 3-year prevalence of nosocomial infection was 0.49%(883/179 439).After propensity score matching,the nosocomial infection group spent an average of 4 927.76 yuan more on antimicrobial drugs than the control group(P<0.001),and the increase cost was 2.39 times more than the control group.The average length of hospital stay in the nosocomial infection group was 18.00 days longer than that in the control group(P<0.001),which was 1.00 times higher than that in the control group.The average cost of hospitalization in nosocomial infection group was 38 377.99 yuan more than that in the control group(P<0.001),which was 1.32 times more than that in the control group.CONCLUSION The propensity score matching increased the comparability of the direct economic burden between the nosocomial infection group and the control group.The nosocomial infection in the hospital of traditional Chinese medicine substantially increased the hospitalization days,antimicrobial drug costs and hospitalization costs of inpatients.In addition to actively implementing infection control measures related to traditional Chinese medicine specialty diagnosis and treatment to reduce the risk of infection,Chinese medicine hospitals should effectively utilize the characteristics of traditional Chinese medicine to reduce the burden of antimicrobial drug costs for nosocomial infections in Chinese hospitals.