基于DRG管理的肿瘤相关疾病医院感染直接经济负担评价  

Evaluation of direct economic burden induced by nosocomial infection of patients with tumor-related diseases based on DRG

作　　者：林臻[1] 祝晓强[2] 陈致宁 黄倩倩[1] 姜沪 张国强 黄谷瑜 蒙莉艳 LIN Zhen;ZHU Xiao-qiang;CHEN Zhi-ning;HUANG Qian-qian;JIANG Hu;ZHANG Guo-qiang;HUANG Gu-yu;MENG Li-yan(The Affiliated Tumor Hospital of Guangci Medical University,Nanning,Guangri 53002l,China;不详)

机构地区：[1]广西医科大学附属肿瘤医院感染管理科,广西南宁530021 [2]广西医科大学附属肿瘤医院医疗保险服务办公室,广西南宁530021 [3]广西大学公共管理学院,广西南宁530004

出　　处：《中华医院感染学杂志》2023年第9期1417-1421,共5页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区卫健委科研基金资助项目(Z20211251)。

摘　　要：目的基于疾病诊断相关分组(DRG),评估肿瘤相关疾病医院感染所致直接经济负担。方法回顾性分析2021年某省三级甲等肿瘤治疗中心全部DRG出院患者资料,比较发生医院感染与未发生医院感染患者平均住院时间和平均住院费用,分析医院感染直接经济负担。结果实行DRG管理的住院患者共19386例次,其中发生医院感染68例次,未发生医院感染13154例次,医院感染患者占DRG管理患者的0.35%;医院感染患者的平均住院日、平均住院费用均高于未发生医院感染患者(P<0.05);主要医院感染部位依次为呼吸系统、手术部位、血液系统和泌尿系统,分别占36.8%、22.1%、19.1%及10.3%;医院感染患者主要集中DRG编码为RE11、RE13、RC11、RW21、BB21、RD11的6个组,其中平均住院日差异最大的诊断细分组为RE13,医院感染患者平均住院天数为DRG同组未发生医院感染患者的5.67倍;平均住院费用差异最大的诊断细分组为RW21,医院感染患者平均住院费用为DRG同组未发生医院感染患者的7.75倍。结论住院患者发生医院感染将显著增加直接经济负担,在DRG支付方式下,定期评估医院感染患者在DRG中的分布及其所致的直接经济负担,以便更精准地开展医院感染目标性监测与危险因素干预。OBJECTIVE To evaluate the direct economic burden induced by nosocomial infection in patients with tumor-related diseases based on diagnosis related groupings(DRGs).METHODS The data were collected from all of DRG patients who were discharged from a three-A tertiary tumor center in 2021,the data were retrospectively analyzed.The average length of hospital stay and average hospitalization cost were compared between the patients with nosocomial infection and the patients without nosocomial infection,and the direct economic burden induced by the nosocomial infection was observed.RESULTS Among 19386 case-times of hospitalized patients for whom the DRG was carried out,68 case-times of patients had nosocomial infection,and 13154 case-times of patients did not have nosocomial infection.The patients with nosocomial infection accounted for 0.35%among the DRG patients.The average length of hospital stay and average hospitalization cost of the patients with nosocomial infection were more than those of the patients without nosocomial infection(P<0.05).Among the patients with nosocomial infection,the patients with respiratory system infection accounted for 36.8%,the patients with surgical site infection 22.1%,the patients with blood system infection 19.1%,the patients with urinary system infection 10.3%.The DRG codes of RE11,RE13,RC11,RW21,BB21 and RD11 were the major 6 groups for the patients with nosocomial infection,the diagnosis subdivision group with the largest difference in average length of hospital stay was RE13.In the same DRG group,the average length of hospital stay of the patients with nosocomial infection was 5.67 times as long as the patients without nosocomial infection;the diagnosis subdivision group with the largest difference in the average hospitalization cost was RW21.In the same DRG group,the average hospitalization cost of the patients with nosocomial infection was 7.75 times as much as the patients without nosocomial infection.CONCLUSION The nosocomial infection may remarkably increase the direct economi

关 键 词：疾病诊断相关分组 肿瘤 医院感染 疾病负担 住院日数 住院费用 

分 类 号：R197.322[医药卫生—卫生事业管理]