早产儿医院感染直接经济损失及其影响因素  

Influencing factors for direct economic loss due to nosocomial infection in premature infants

作　　者：卢婉婷 施春兰 林志鹏[1] 洪雅芳 黄素玲[1] LU Wan-ting;SHI Chun-lan;LIN Zhi-peng;HONG Ya-fang;HUANG Su-ling(First Hospital of Quanzhou City,Quanzhou,Fujian 362000,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]泉州市第一医院院新生儿重症监护室,福建泉州362000

出　　处：《中华医院感染学杂志》2024年第3期426-431,共6页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金资助项目(2018J01199)。

摘　　要：目的分析早产儿医院感染直接经济损失的影响因素.方法回顾性收集泉州市第一医院2018年1月-2022年12月新生儿重症监护室早产儿的资料,采用递归系统模型分析各因素对早产儿医院感染直接经济损失的影响.结果共纳入1205例早产儿,医院感染124例,感染率为10.29%;经倾向指数匹配法共成功匹配121对;早产儿医院感染组和非感染组住院天数中位数分别为34 d和7 d,医院感染组较非医院感染组住院时间延长27 d(P<0.001);医院感染组住院费用中位数为39636.94元,非医院感染组为8982.02元,医院感染组住院费用较非医院感染组多支出30654.92元(P<0.001);在增加的费用中,以药费、治疗费和检查费为主;出生体质量对早产儿医院感染直接经济损失既存在直接效应又存在间接效应,影响最大;住院天数、胃管留置和气管插管仅有直接效应;胎龄和抗菌药物使用天数仅有间接效应.结论临床实践中需重点关注出生体质量<1500 g和胎龄<32周的早产儿、尽可能缩短住院天数、减少侵入性操作、控制抗菌药物使用天数,从而控制住院费用,减少患儿经济负担.OBJECTIVE To analyze the factors influencing the direct economic loss of nosocomial infection in premature infants.METHODS Data on premature infants in the Neonatal Intensive Care Unit of the First Hospital of Quanzhou City from Jan.1,2018 to Dec.31,2022 were retrospectively collected,and recursive system modeling was used to analyze the impact of each factors on the direct economic loss of nosocomial infection in premature infants.RESULTS A total of 1205 cases of premature infants were included,124 patients had nosocomial infection,with an infection rate of 10.29%.A total of 121 pairs were successfully matched by the propensity score matching method.The median hospitalization days of preterm infants in the nosocomial infection group and non-hospital in-fection group were 34 and 7 days,respectively,with the nosocomial infection group having a longer hospitalization time of 27 days compared with the non-hospital infection group(P<0.001).The median of hospitalization cost of the nosocomial infection group was 39636.94 yuan and 8982.02 yuan in the non-hospital infection group,and the hospitalization cost in the nosocomial infection group was 30654.92 yuan more than that in the non-hospital infection group(P<0.001).Among the increased costs,the costs of medicines,treatments,and examinations were the main sources of costs.Birth weight had both a direct and an indirect effect on the direct economic loss of noso-comial infection in premature infants,with the greatest impact.The index such as hospitalization days,gastric tube retention and tracheal intubation had only a direct effect,while the index such as gestational age and the number of days of antimicrobial drug use had only an indirect effect on economic losses of nosocomial infection in premature infants.CONCLUSION In clinical practice,it is necessary to focus on premature infants with birth weight mass<1500 g and gestational age<32 weeks,shorten the number of hospitalization days as much as possible,reduce invasive procedures,and control the days of antimicrobial

关 键 词：早产儿 医院感染 直接经济损失 递归系统模型 影响因素 影响效应 

分 类 号：R183[医药卫生—流行病学]