低出生体重儿医院感染经济负担分析  

Economic burden of healthcare-associated infection in low birth weight infants

作　　者：卢婉婷 薛桦芳 洪雅芳 黄志扬 LU Wan-ting;XUE Hua-fang;HONG Ya-fang;HUANG Zhi-yang(Department of Healthcare-associated Infection Control,Quanzhou First Hospital,Quanzhou 362000,China;Department of Healthcare-associated Infection Management,Hospital of Fuqing City,Fuzhou 350300,China)

机构地区：[1]泉州市第一医院院内感染控制科,福建泉州362000 [2]福清市医院医院感染管理科,福建福州350300

出　　处：《中国感染控制杂志》2024年第3期344-350,共7页Chinese Journal of Infection Control

摘　　要：目的 分析低出生体重儿医院感染所造成的经济负担,为制定医院感染相关政策提供理论依据。方法 回顾性收集某三级甲等医院2018年1月—2022年12月新生儿科低出生体重儿的资料,采用倾向指数匹配法和边际分析法评估医院感染给低出生体重儿和医院带来的经济损失。结果 共纳入1 048例低出生体重儿,发生医院感染124例,医院感染发病率为11.8%。经倾向指数匹配法共成功匹配109对。医院感染组和非医院感染组低出生体重儿住院中位日数分别为34.0、11.0 d,医院感染组低出生体重儿延长住院日数23 d(P<0.001)。医院感染组和非医院感染组低出生体重儿住院总费用的中位数分别为38 067.6、12 375.7元,医院感染组低出生体重儿多支出住院总费用25 691.9元(P<0.001);在增加的费用中,以检查费、治疗费和药费为主。不同体重低出生体重儿医院感染组住院总费用均高于非医院感染组,差异均有统计学意义(均P<0.05)。胎龄<32周低出生体重儿住院时间更长,住院总费用更高,差异均有统计学意义(均P<0.05)。当边际利润率分别为5%、10%、15%时,医院感染导致医院经济损失分别为37.1万元、74.2万元、111.4万元;损失利润比为0.33,损失利润与感染系数比值为2.79。结论 医院感染给低出生体重儿和医院带来巨大的经济损失,出生体重≤1 000 g组和胎龄<32周低出生体重儿是重点防控人群。可通过损失利润与感染系数比值估计医院的经济损失,及时调整感染控制措施,降低医院感染发病率。Objective To analyze the economic burden due to healthcare-associated infection(HAI)in low birth weight(LBW)infants,and provide theoretical basis for formulating HAI related policies.Methods The data of LBW infants in a tertiary first-class hospital from January 2018 to December 2022 were retrospectively collected.Propensity score matching method and marginal analysis were adopted to evaluate the economic losses in LBW infants and hospitals due to HAI.Results A total of 1048 LBW infants were included in analysis,124 of whom had HAI,with HAI incidence of 11.8%.A total of 109 pairs were successfully matched using the propensity score matching method.The median length of hospital stay for LBW infants in the HAI group and non-HAI group were 34.0 and 11.0 days,respectively,the length of hospital extended 23 days in LBW infants in the HAI group(P<0.001).The median hospitalization expenses for LBW infants in HAI group and non-HAI group were 38067.6 and 12375.7 Yuan,respectively,the hospitalization expense for LBW infants in HAI group was 25691.9 Yuan more than non-HAI group(P<0.001).The major increased expenses were examination,treatment and medication fees.The total hospitalization expenses in different birth weight LBW infants in HAI group were all higher than non-HAI group,and the differences were all statistically significant(all P<0.05).LBW infants with gestational age<32 weeks had longer length of hospital stay and higher total hospitalization expense,differences were all statistically significant(all P<0.05).When the marginal profit ratios were 5%,10%,and 15%,respectively,the economic losses caused by HAI were 371000 Yuan,742000 Yuan,and 1114000 Yuan,respectively;The ratios of loss-profit and loss-profit to infection coefficient were 0.33 and 2.79,respectively.Conclusion HAI cause significant economic losses to both LBW infants and hospitals.Infants with a birth weight≤1000 g and those with a gestational age<32 weeks are key populations for prevention and control.The lost-profit to infection coefficient can be

关 键 词：低出生体重儿 医院感染 边际利润率 经济负担 

分 类 号：R197.323.4[医药卫生—卫生事业管理]