急性白血病患者医院感染直接经济损失病例对照研究
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摘要
目的:了解某三级甲等中医院急性白血病患者发生医院感染所造成的直接经济损失,为感控措施的落实提供依据。方法:采用回顾性调查的方法,对某中医院血液科2015年1月～2016年12月收治的596例急性白血病患者进行调查,按匹配条件1∶1配对成功71组,分为病例组和对照组。采用秩和检验的方法比较两组住院费用及住院日数的差异。结果:病例组平均住院费用中位数为74 927元,对照组为22 612元,平均增加费用52 315元,差异具有统计学意义(Z=-7. 323,P <0. 001);病例组平均住院日数中位数为29 d,对照组为17 d,平均增加12 d,差异均有统计学意义(Z=-7. 325,P <0. 001)。感染部位中多部位感染、下呼吸道感染、血流感染增加的费用最多。结论:发生医院感染明显增加患者经济负担,在系统治疗的基础上发挥中医、中药特色并加强各项感染控制措施的落实,达到控制医院感染减轻患者经济负担的目的。
Objective To investigate the direct economic loss caused by nosocomial infection in patients with acute leukemia in a tertiary TCM hospital,and to provide the basis for implementing infection prevention and control measures. Method We retrospectively investigated 596 inpatients with acute leukemia admitted in Hematological disease department in a tertiary TCM hospital from January 2015 to December 2016. The 1 ∶ 1 conditional matching was carried out for 71 pair inpatients including nosocomial infection cases( case group) and without nosocomial infection cases( control group). The medical cost and length of hospital stay were observed and compared between the case group and the control group by means of Paired rank sum test. Results The median hospitalization expense of patients in case group was $ 74 927,and $ 22 612 in control group,the average cost increase was $ 52 315,the difference was statistically significant( Z =-7. 323,P < 0. 001). The median length of hospital stay of the case group was 29 days,significantly longer than 17 days of the control group( Z =-7. 325,P < 0. 001).The average duration increase was 12 days. The most common increased cost caused by multi-site infection,lower respiratory tract infection and bloodstream infection. Conclusion The medical cost of patients with nosocomial infections is significantly higher than that of the patients without nosocomial infection. Make use of features of Traditional Chinese Medicine on the basis of standard treatment,and strengthen the implementation of infection control measures,may be a way to decrease nosocomal infection and cut down the economic burden of patients.
Objective To investigate the direct economic loss caused by nosocomial infection in patients with acute leukemia in a tertiary TCM hospital,and to provide the basis for implementing infection prevention and control measures. Method We retrospectively investigated 596 inpatients with acute leukemia admitted in Hematological disease department in a tertiary TCM hospital from January 2015 to December 2016. The 1 ∶ 1 conditional matching was carried out for 71 pair inpatients including nosocomial infection cases( case group) and without nosocomial infection cases( control group). The medical cost and length of hospital stay were observed and compared between the case group and the control group by means of Paired rank sum test. Results The median hospitalization expense of patients in case group was $ 74 927,and $ 22 612 in control group,the average cost increase was $ 52 315,the difference was statistically significant( Z =-7. 323,P < 0. 001). The median length of hospital stay of the case group was 29 days,significantly longer than 17 days of the control group( Z =-7. 325,P < 0. 001).The average duration increase was 12 days. The most common increased cost caused by multi-site infection,lower respiratory tract infection and bloodstream infection. Conclusion The medical cost of patients with nosocomial infections is significantly higher than that of the patients without nosocomial infection. Make use of features of Traditional Chinese Medicine on the basis of standard treatment,and strengthen the implementation of infection control measures,may be a way to decrease nosocomal infection and cut down the economic burden of patients.
引文
[1]中华人民共和国卫生部.医院感染诊断标准(试行)[S].北京,2001.
[2]国家统计局社会科技和文化产业统计司.中国社会统计年鉴[M].北京:中国统计出版社,2014:1.
[3]王书会,王静娜,刘芸宏,等.急性白血病患者医院感染直接经济损失调查与分析[J].中华医院感染学杂志,2015,25(15):3578.
[4]车飞.某大型综合医院医院感染现状及其所在直接经济学损失研究[D].山西:山西医科大学,2010.
[5]周晓平,黄继峥.罗腾达,等.医院感染经济损失1:1匹配病例对照研究[J].中华医院感染学杂志,2016,26(18):4268.
[6]殷环,赵秀莉,李六亿.某三级甲等综合医院医院感染经济损失的研究[J].中华医院感染学杂志,2014,24(21):5393.
[7]刘芸宏,王书会,王静娜,等.急性白血病患者口腔感染直接经济损失分析[J].中国感染控制杂志,2016,15(10):785.
[8] Roberts R R,Scott R N,Hota B,et al. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods[J]. Med Care,2010,48(11):1026.
[9]贾会学,侯铁英,李卫光,等.中国68所综合医院医院感染的经济损失研究[J].中国感染控制杂志,2016,15(9):637.
[10] Stevens V,Geiger K,Concannon C,et al. Inpatient costs,mortality and 30-day re-admission in patients with centralline-associated bloodstream infectiona[J]. Clin Microbiol Infect,2014,20(5):O318.
[11]戴正香,黄芳.复方杞菊汤漱口防治化疗相关口腔感染的疗效观察[J].护理研究,2014,28(4):1338.
[12]黄文峰.浅谈非营利性医院的经济效益管理[J].吉林医学,2009,30(21):2687.
[2]国家统计局社会科技和文化产业统计司.中国社会统计年鉴[M].北京:中国统计出版社,2014:1.
[3]王书会,王静娜,刘芸宏,等.急性白血病患者医院感染直接经济损失调查与分析[J].中华医院感染学杂志,2015,25(15):3578.
[4]车飞.某大型综合医院医院感染现状及其所在直接经济学损失研究[D].山西:山西医科大学,2010.
[5]周晓平,黄继峥.罗腾达,等.医院感染经济损失1:1匹配病例对照研究[J].中华医院感染学杂志,2016,26(18):4268.
[6]殷环,赵秀莉,李六亿.某三级甲等综合医院医院感染经济损失的研究[J].中华医院感染学杂志,2014,24(21):5393.
[7]刘芸宏,王书会,王静娜,等.急性白血病患者口腔感染直接经济损失分析[J].中国感染控制杂志,2016,15(10):785.
[8] Roberts R R,Scott R N,Hota B,et al. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods[J]. Med Care,2010,48(11):1026.
[9]贾会学,侯铁英,李卫光,等.中国68所综合医院医院感染的经济损失研究[J].中国感染控制杂志,2016,15(9):637.
[10] Stevens V,Geiger K,Concannon C,et al. Inpatient costs,mortality and 30-day re-admission in patients with centralline-associated bloodstream infectiona[J]. Clin Microbiol Infect,2014,20(5):O318.
[11]戴正香,黄芳.复方杞菊汤漱口防治化疗相关口腔感染的疗效观察[J].护理研究,2014,28(4):1338.
[12]黄文峰.浅谈非营利性医院的经济效益管理[J].吉林医学,2009,30(21):2687.