某三级甲等综合医院医院感染经济损失的研究  

Economic losses induced by nosocomial infections in a three A hospital

作　　者：殷环[1] 赵秀莉[1] 李六亿[1] 

机构地区：[1]北京大学第一医院感染管理-疾病预防控制处,北京100034

出　　处：《中华医院感染学杂志》2014年第21期5393-5395,共3页Chinese Journal of Nosocomiology

基　　金：卫生部卫生标准制(修)订基金资助项目(20121301)

摘　　要：目的探讨某三级甲等综合医院患者发生医院感染所造成的经济损失及其影响因素,使医院管理者对医院感染的危害有更直观的认识,从而增加对医院感染管理的重视程度。方法 2013年1-12月采用1∶1病例对照研究方法,回顾性调查394对医院感染和非医院感染患者的相关资料,采用配对秩和检验比较病例组和对照组的医疗费用和住院日数差异,计算医院感染给患者造成的经济损失,并分析经济损失的影响因素。结果医院感染患者平均医疗费用(中位数)为43 407元,住院日数(中位数)为26.0d,非医院感染患者平均医疗费用为16914元,住院日数为13.0d,平均每例患者由医院感染所造成的经济损失为29 846元,其中直接医疗费用损失26493元,直接非医疗费用损失877元,间接经济损失2 476元,延长住院时间13d,增加的医疗费用和住院日数随感染部位不同而异,多部位感染增加的医疗费用最多,为81 196元;手术部位感染延长住院日数最多,为20d。结论发生医院感染明显增加患者的医疗费用和住院时间,给患者造成巨大的经济损失。OBJECTIVE To explore the economic losses caused by nosocomial infections in a three A general hospital and observe the influencing factors and make the infection control staff be aware of the hazard of nosocomial infec-tions so as to pay increasing attention to the control of nosocomial infections .METHODS A retrospective 1 ：1 matched case-control study was conducted to collect relative information of patients with nosocomial infections and patients without nosocomial infections ,and totally 394 pairs of patients were included .The wilcoxon signed ranks test was carried out to compare the medical expenses and the hospitalization duration ,the economic losses cased by the nosocomial infections were calculated ,and the influencing factors for the economic losses were analyzed . RESULTS The median medical expenses of the patients with nosocomial infections was 43 407 yaun ,the patients without nosocomial infections 16 914 yuan;the median hospitalization duration of the patients with nosocomial in-fections was 26 .0 days ,the patients without nosocomial infections 13 .0 days .The average economic losses caused by the nosocomial infections in each patient was 29 846 yaun ,including 26 493 yuan of direct losses of medical ex-pense ,877 yuan of direct losses of non-medical expense ,and 2 476 yuan of indirect economic losses ;the hospitali-zation duration was extended to 13 days .The increase of medical expenses and the hospitalization duration varied with the infection sites .The increase of the medical expense induced by multi-site infections was greatest （ 81 196 yuan）;the hospitalization duration was extended to the longest of 20 days due to the surgical site infections . CONCLUSION The nosocomial infections may significantly increase the medical expenses or extend the hospitaliza-tion duration ,which brings great economic losses to the patients .

关 键 词：医院感染 经济损失 住院日数 病例对照研究 

分 类 号：R197.323[医药卫生—卫生事业管理]