神经系统疾病医院感染疾病负担的诊断相关分组分析  

Burden of nosocomial infection in nervous system disease patients based on diagnosis related groupings

作　　者：韩叙[1] 王力红[1] 李小莹[2] 仇叶龙[2] 张京利[1] 赵霞[1] 马文晖[1] 赵会杰[1] 王允琮 HAN Xu;WANG Li-hong;LI Xiao-ying;QIU Ye-long;ZHANG Jing-li;ZHAO Xia;MA Wen-hui;ZHAO Hui-jie;WANG Yun-cong(Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院医院感染管理处,北京100053 [2]首都医科大学宣武医院医院医务处,北京100053

出　　处：《中华医院感染学杂志》2021年第18期2860-2863,共4页Chinese Journal of Nosocomiology

基　　金：北京市属医院科研培育计划基金资助项目(PG2019018)。

摘　　要：目的基于诊断相关分组分析方法,探究神经系统疾病医院感染的疾病负担。方法回顾性收集2019年北京市某三级甲等综合医院主要诊断类别为神经系统疾病及功能障碍的全部病例的诊断相关分组信息和医院感染信息,基于诊断相关分组,采用时间消耗指数和费用消耗指数,比较医院感染组与非医院感染组住院时间及住院费用差异,并进一步分层分析各诊断相关组的医院感染疾病负担情况。结果神经系统疾病及功能障碍组患者中医院感染组病死率为3.78%,平均住院日为21.98d,例均费用为10.52万元,均高于非医院感染组(P<0.001);时间消耗指数为1.56、费用消耗指数为1.93,分别为非医院感染组的1.73倍和2.17倍。时间消耗差异最大的诊断细分组为BV16(癫痫病<17岁,不伴合并症与伴随病)组(Z=2.854,P=0.004),其医院感染组平均住院天数为非医院感染组2.64倍;费用消耗差异最大的诊断细分组为BR33(颈部血管疾患,伴合并症与伴随病)组(Z=1.972,P=0.049),其医院感染组例均费用为非医院感染组的11.90倍。结论医院感染显著增加神经系统疾病的疾病负担,基于诊断相关分组方法可更加准确细化评价医院感染疾病负担。OBJECTIVE To explore the burden of nosocomial infection in nervous system disease patients based on diagnosis related groupings(DRGs).METHODS the DRGs information and information of nosocomial infection were retrospectively collected from all the cases who were diagnosed with nervous system diseases and dysfunction in a tertiary three A hospital in 2019.The length of hospital stay and hospitalization cost were compared between the nosocomial infection group and the non-nosocomial infection group by using time consumption indexes and cost consumption indexes,and further stratification analysis was performed for the burden of nosocomial infection.RESULTS Among the patients who were diagnosed with nervous system diseases and dysfunction,the mortality rate,average length of hospital stay and cost per case of the nosocomial infection group were respectively 3.78%,21.98days and 105,200yuan,significatly higher than those of the non-nosocomial infection group(P<0.001);the time consumption index was 1.56,1.73times as the non-nosocomial infection group,the cost consumption index was 1.93,2.17times as the non-nosocomial infection group.The patients with the most significant difference in time consumption were subdivided as the BV16group(epilepsy less than 17years old,without complications and other diseases)(Z=2.854,P=0.004),the average length of hospital stay of the nosocomial infection group was 2.64times as that of the non-nosocomial infection group.The patients with most significant difference in the cost consumption were subdivided as the BR33group(neck vascular diseases,with complications and other diseases),(Z=1.972,P=0.049),and the average cost of the nosocomial infection group was 11.86times as that of the nonnosocomial infection group.CONCLUSION The nosocomial infection may remarkably increase the burden of the patients with nervous system disease,and DRGs can evaluate the burden of nosocomial infection more accurately and detailed.

关 键 词：医院感染 疾病诊断相关组 疾病负担 神经系统疾病 

分 类 号：R197.322[医药卫生—卫生事业管理]