儿童医院ICU呼吸机相关性肺炎经济损失配比病例对照研究  

Cost analysis of ventilator-associated pneumonia in children:a case-control study

作　　者：郭巧芝 赵丹洋 司徒敏雄 周轶 张穗平 何通杰 

机构地区：[1]广州市妇女儿童医疗中心医院感染控制科,广东广州510120

出　　处：《中华医院感染学杂志》2015年第13期3089-3091,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2012B061700011)

摘　　要：目的分析儿童专科医院ICU呼吸机相关性肺炎(VAP)造成的直接经济损失。方法选择2012年1月1日-12月31日入住新生儿和儿童ICU应用机械通气治疗时间>48h后发生VAP的患儿作为病例组,选择同期性别、年龄、入院主要诊断和入院时疾病严重程度相近且应用机械通气治疗时间>48h后未发生VAP的患儿作为对照组,采用配比秩和检验分析住院费用的组间差异。结果病例组与对照组患儿机械通气时间分别为13d和6d(P<0.001),住ICU时间分别为24d与14d(P<0.001);病例组住院总费用中位值为90 222.0元,高于对照组的48 386.3元,病例组平均增加住院费用41 835.7元,病例组和对照组费用中位值相差较高的费用类型主要为治疗费、药费、检查费和化验费。结论 VAP延长患儿住院时间和增加住院费用,认真做好干预措施可预防住院患儿VAP的发生率,以降低经济损失。OBJECTIVE To characterize the economic burden of ventilator‐associated pneumonia （VAP） and to de‐termine which services increase the cost of VAP in a tertiary care pediatric center .METHODS A retrospective matched case‐control study was performed in the study .All newborns and children in ICU mechanically ventilated for﹥48 hours from Jan .1 to Dec .31 in 2012 were assessed .Children with confirmed VAP （n=45） were identi‐fied and were matched by patients without VAP （n=45） of similar age ,gender ,primary diagnosis on admission and severity of diseases as controls .Between‐group differences in hospital cost were analyzed by use of the Wilcox‐on‐Whitney signed‐rank test .RESULTS Median total costs per patient were 90 222 .0 yuan for case patients ,higher than 48 386 .3 yuan for matched control patients .The median duration of mechanical ventilation was significantly longer for case patients than for control patients （13 days vs .6 days ,P〈0 .001） ,as were the median duration of ICU stay （24 days vs .14 days ,P〈0 .001） .Services likely to be directly related to VAP with higher median costs for case patients and control patients were treatment ,drugs and examination .CONCLUSION VAP prolongs dura‐tion of hospital stay and increases hospital costs ,careful intervention can prevent incidence of VAP in children so as to reduce economic burden .

关 键 词：重症监护病房 呼吸机相关性肺炎 患儿 经济损失 病例对照 

分 类 号：R563.1[医药卫生—呼吸系统]