多药耐药与非耐药鲍曼不动杆菌院内感染的归因住院费用与住院时长研究  

Study of Attributive Hospitalized Cost and Length of Stay for Hospital Acquired Infection due to Multidrug Resistance and None-resistance Acinetobacter Baumannii

作　　者：郭轶斌[1] 郭威[1] 邱佩琪 何倩[1] 潘传迪 吴骋[1] 贺佳[1] 

机构地区：[1]第二军医大学卫生勤务学系卫生统计学教研室,200433 [2]上海长海医院医教部医疗科 [3]浙江省智慧医疗工程技术研究中心

出　　处：《中国卫生统计》2017年第3期378-381,共4页Chinese Journal of Health Statistics

基　　金：上海市循证公共卫生与卫生经济学重点学科项目(15GWZK0901);总后优秀青年科技人才扶持对象资助项目;上海市卫计委课题(20154Y0074);浙江省智慧医疗工程技术研究中心资助(2016E1011)

摘　　要：目的探索多药耐药和非耐药鲍曼不动杆菌院内感染患者的归因住院费用与住院时长。方法通过回顾性队列,采用倾向性评分匹配法均衡队列中暴露组与非暴露组患者的基线水平。使用Bootstrap法估计归因住院费用和住院时长的均数、中位数,及其95%置信区间。结果对于多药耐药和非耐药患者,因鲍曼不动杆菌感染的归因住院时长均数分别为12.62和7.80天(95%CI:9.62~16.07天和5.75~10.01天),中位数为9和4天(95%CI:8~11天和2~6天)。归因住院总费用均数为$40678.63和$33794.91(95%CI:$26333.13~54958.49和$25638.79~42719.25),中位数为$26693.90和$16584.91(95%CI:$17528.79~39445.14和$11809.05~21673.57)。结论院内鲍曼不动杆菌感染会增加住院患者住院时长,加重患者的经济负担,对于多药耐药的患者更为明显。Objective To explore the attributive cost and length of stay for hospital acquired Infection due to multidrug resistance and none-resistance Acinetobacter baumannii. Methods By conducting a retrospective cohort,propensity score matching was used to balance the different baseline between exposure and non-exposure. And Bootstrap method was used to estimate the mean, median and 95% confidence interval of attributive hospitalized cost and length of stay. Results For those who are multidrug resistance and non-resistance Acinetobacter baumannii, the attributive mean of length of stay are 12. 62 and 7.80 respectively（95% CI：9. 62 - 16. 07 and 5.75 - 10. 01 ） ,median are 9 and 4 respectively（95% CI：8 - 11 and 2 - 6）. The mean of attributive hospitalized costs are ￥ 40678.63 and ￥ 33794. 91 （95% CI： ￥26333.13 -54958.49 and ￥ 25638. 79 -42719. 25 ）, median are ￥ 26693.90and ￥ 16584. 91 （95% CI： ￥ 17528.79 -39445.14 and ￥ 11809. 05 -21673.57 ）. Conclusion The hospital acquired infection of Acinetobacter baumannii can raise the length of stay and increase patient＇s economic burden, especially for those who are multidrug resistance infected.

关 键 词：院内感染 鲍曼不动杆菌 归因 住院费用 住院时长 耐药 

分 类 号：R197.3[医药卫生—卫生事业管理]