神经外科开颅手术患者术后医院感染直接经济损失评价  

Evaluation of direct economic loss caused by nosocomial infection after neurosurgery craniotomy

作　　者：袁文清[1] 李玲[2] 吕维红[2] 唐思魏 张晓 徐钰雯 张磊[2] 谭善娟[2] Yuan Wenqing;Li Ling;Lyu Weihong;Tang Siwei;Zhang Xiao;Xu Yuwen;Zhang Lei;Tan Shanjuan(Department of Basic Medical Management,Qingdao Municipal Hospital,Qingdao,Shandong,266071,P.R.China;Depart-ment of Hospital Infection Management,Qingdao Municipal Hospital,Qingdao,Shandong,266071,P.R.China;Department of Neurosurgery,Qingdao Municipal Hospital,Qingdao,Shandong,266071,P.R.China)

机构地区：[1]青岛市市立医院基层医疗管理部,山东青岛266071 [2]青岛市市立医院医院感染管理科,山东青岛266071 [3]青岛市市立医院神经外科,山东青岛266071

出　　处：《老年医学与保健》2022年第4期751-755,共5页Geriatrics & Health Care

摘　　要：目的 探讨神经外科开颅手术患者术后医院感染所造成的直接经济损失及特点,为决策者和医务人员防控医院感染提供科学依据。方法 收集青岛市某三级甲等医院2018年1月—2020年12月神经外科开颅手术后发生医院感染的258例患者为病例组,按1∶1配对方法,选择未发生医院感染的开颅手术患者258例为对照组,采用配对设计的秩和检验或独立样本的秩和检验方法,比较2组的直接经济损失及住院日数差异。结果 病例组与对照组相比,住院日(中位数)增加13.5 d(Z=-12.051,P<0.001),住院费用(中位数)增加97 278.9元(Z=-15.682,P<0.001)。在MDRO感染组、非MDRO感染组和对照组间进行住院时间与住院费用的比较,结果发现除手术治疗费(P>0.05)外,其它指标的差异均有统计学意义(P<0.05);MDRO感染组与非MDRO感染组相比,住院日和影像诊断费用差异无统计学意义(P>0.05),其他费用均高于非MDRO感染组(P<0.05)。SSI组和其他感染组住院时间差异有统计学意义(χ^(2)=-2.460,P=0.014),SSI组手术费用和抗菌药物费用高于术后肺炎组和其他感染患者组(P<0.05)。结论 开颅手术患者术后发生医院感染导致住院日延长,住院费用增加,多重耐药菌感染导致的住院日延长和住院费用增加更为显著,应采取措施进行防控。Objective To explore the direct economic loss and characteristics caused by nosocomial infection after neurosurgery craniotomy,and provide scientific basis for decision makers and medical staff to prevent and control nosocomial infection.Methods 258 patients with nosocomial infection after neurosurgery craniotomy in a tertiary first-class hospital in Qingdao from January 2018 to December 2020 were selected as the case group.According to the 1:1 matching method,258 craniotomy patients without nosocomial infection were selected as thecontrol group.The rank sum test of paired design or the rank sum test of independent samples was used to compare the direct economic loss and hospitalization days between the two groups.Results Compared with the control group,the hospitalization days(median) of the case group increased by 13.5 days(Z=-12.051,P<0.001),and the hospitalization expenses(median) increased by 97 278.9 yuan(Z=-15.682,P<0.001).The hospitalization time and hospitalization expenses were compared among the MDRO infection group,the non-MDRO infection group and the control group.The results showed that except for the surgical treatment expenses(P>0.05),the differences in other indicators were statistically significant(P<0.05).There was no significant difference in hospitalization days and imaging diagnosis costs between the MDRO infection group and the non-MDRO infection group(P>0.05),but the other costs in the MDRO infection group were higher than those in the non-MDRO infection group(P<0.05).There was a statistically significant difference in hospitalization time between the SSI group and other infection groups(χ^(2)=-2.460,P=0.014).The operation cost and antimicrobial cost of the SSI group were higher than those of the postoperative pneumonia group and other infection groups(P<0.05).Conclusion Nosocomial infection after craniotomy leads to prolonged hospitalization days and increased hospitalization expenses.The prolongation of hospitalization days and the increase of hospitalization expenses caused by multidru

关 键 词：神经外科 医院感染 直接经济损失 开颅手术 

分 类 号：R651.1[医药卫生—外科学] R197.323[医药卫生—临床医学]