ICU病房下呼吸道医院感染经济学损失调查与分析  

Study on Economic Losses of Lower Respiratory Nosocomial Infections in Intensive Care Unit

作　　者：王书会[1,2] 于子旭[3] 荆文华[2] 邓钰[4] 王海燕[2] 李士雪[1] 

机构地区：[1]山东大学公共卫生学院社会医学与卫生事业管理研究所,济南250012 [2]山东大学齐鲁医院感染管理科,济南250012 [3]山东大学附属省立医院护理部,济南250021 [4]山东大学附属省立医院儿外科,济南250021

出　　处：《中国卫生经济》2012年第2期36-38,共3页Chinese Health Economics

基　　金：山东省科技攻关计划项目(2007GG10002009)

摘　　要：目的:研究ICU住院患者因下呼吸道医院感染所造成的直接经济损失。方法:采用回顾性调查和前瞻性监测的方法,调查2004年1月1日至2010年12月31日某三级甲等教学医院综合性ICU病房的住院患者,共收集病例2060例。按条件1∶1配比,共成功配对147对(发生下呼吸道医院感染的患者为病例组,未发生医院感染的患者为对照组),比较他们的住院费用和住院天数的差别。结果:病例组住院总费用中位数每例为104 156.50元,对照组为31 407.66元,病例组显著高于对照组(P<0.05);费用的增加主要是药费和治疗费;ICU下呼吸道感染经济损失排在前三位的疾病种类为复合伤、消化系统疾病和循环系统疾病,病例组与对照组差异均有统计学意义(P﹤0.05)。病例组中位数每例患者住院天数为20.0天,对照组为6.0天,两组间差异有统计学意义(P<0.05)。结论:ICU患者下呼吸道医院感染大大增加了医疗费用支出,延长了住院天数,降低了病床周转率,其费用支出远高于非医院感染患者,做好ICU患者下呼吸道医院感染的防控可获得巨大经济效益和社会效益。Objective： To evaluate the direct economic costs of lower respiratory nosocomial infections in Intensive Care Unit（ICU）.Methods： The retrospective study and prospective survey were conducted,and according to the mate conditions,147 pairs of cases（patients with lower respiratory nosocomial infection were described as infection group and patients without nosocomial infection were described as control group） that were collected in a tertiary teaching hospital from January,2004 to December,2010.The direct economic losses and the time of hospitalization were analyzed.Results： The median of total hospitalization expenses of each case were 104 156.50 yuan and 31 407.66 yuan in infection and control group respectively,infection group was significantly higher than control group（P0.05）.The main increased expenses of hospitalization were medicine costs and therapy costs.The direct economic loss of nosocomial infection of patients with complex trauma ranked first,followed by patients with digestive system disease and patients with circulation system disease.The median of hospitalization days of each patient in infection group and control group were 20.0 and 6.0 days respectively.There was significant difference between them（P0.05）.Conclusions： Lower respiratory nosocomial infections of ICU inpatients during hospitalization caused significant increase in the medical expense of managing the underlying disease,which led to hospitalization of the patients and reduced the turnover rate of patient bed,and cost of nosocomial infection was much more than that for common nosocomial infections.Good measures of controlling Lower respiratory nosocomial infection could bring tremendous social and economic benefits.

关 键 词：ICU 下呼吸道 医院感染 经济损失 

分 类 号：R197.3[医药卫生—卫生事业管理]