基于DRG管理的珠海市某三甲医院医院感染患者疾病经济负担  

Study of economic burden due to hospital-acquired infection based on DRG management in a three-A hospital of Zhuhai

作　　者：刘日纯 刘旭 陈玲[1] LIU Ri-chun;LIU Xu;CHEN Ling(The Fifth Affiliated Hospital Sun Yat-sen University,Zhuhai,Guangdong 519000,China)

机构地区：[1]中山大学附属第五医院医院感染管理科,广东珠海519000 [2]中山大学附属第五医院感染病防治中心,广东珠海519000

出　　处：《中华医院感染学杂志》2025年第1期132-137,共6页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年项目(72204275)。

摘　　要：目的基于疾病诊断相关分组(DRG)付费分析不同分组的医院感染患者对疾病负担的影响。方法采用回顾性分析方法分析2022年珠海市某三甲医院医院感染病例基本信息与全部出院病例的DRG信息,通过总体、主要诊断类别(MDC)组、DRG组分层比较医院感染患者(感染组)与非医院感染患者(非感染组)的平均住院日与平均住院费用。结果2022年入组DRG出院患者共85241例次,医院感染病例共767例次,占所有DRG患者的0.90%。767例次医院感染患者分布在23个MDC组,覆盖230个DRG组,84474例次非医院感染患者分布在26个MDC组,覆盖740个DRG组。感染组的平均住院日和平均住院费用明显高于非感染组(P<0.001)。医院感染病例最为集中的MDC组为骨髓增生性疾病和功能障碍组(MDCR)和神经系统疾病及功能障碍(MDCB),占比分别为29.99%(230/767)和14.73%(113/767)。医院感染最为集中的DRG组为急性白血病高剂量化学治疗和/或其他治疗(RB19)、恶性增生性疾病的支持性治疗(30d≤住院时间<61d)(RU10)和其他开颅术,伴重要并发症与合并症(BB21),占比分别为3.65%(28/767)、3.00%(23/767)和2.87%(22/767)。结论发生医院感染的患者显著增加其经济负担,可通过对发生医院感染集中的MDC组或DRG组进行根因分析,有针对性地进行医院感染防控干预,可有效降低医院感染的发生,提高医院医疗质量,增加医疗效果和效益,减少卫生资源浪费。OBJECTIVE To observe the influence of different groups of hospital-acquired infection on burden of disease based on diagnosis related group(DRG).METHODS The baseline data of patients with hospital-acquired infection and the DRG information of all the patients who were discharged from a three-A hospital in 2022 were retrospectively analyzed.The average length of stay and average hospitalization cost were observed and compared by overall,major diagnosis category(MDC)group and DRG group.RESULTS A total of 85241 case-times of DRG patients who were discharged in 2022 were enrolled in the study,and 767 case-times of patients had hospital-acquired infection,accounting for 0.90%among the DRG patients.The 767 case-times of patients with hospital-acquired infection distributed in 23 MDC groups,covering 230 DRG groups;84474 case-times of non-hospital-acquired infection patients distributed in 26 MDC groups,covering 740 DRG group.The average length of stay of the infection group was remarkably longer than that of the non-infection group,and the average hospitalization cost of the infection group was remarkably more than that of the non-infection group(P<0.001).The myeloproliferative disorders and dysfunction group(MDCR)and neurological diseases and dysfunction(MDCB)were the MDC groups with the most concentrated cases of hospital-acquired infection,accounting for 29.99%(230/767)and 14.73%(113/767),respectively.The patients who received high-dose chemotherapy and/or other therapies for acute leukemia(RB19),supportive therapy for malignant proliferative disease(30 days≤length of stay<61 days)(RU10)and other craniotomies,and were complicated with complications(BB21)were the most concentrated DRG group of hospital-acquired infection,accounting for 3.65%(28/767),3.00%(23/767)and 2.87%(22/767),respectively.CONCLUSION The hospital-acquired infection may remarkably increase the economic burden of the patients.It is necessary to carry out the root-cause analysis for the MDC group or DRG group of concentrated hospital-acquired infect

关 键 词：疾病诊断相关分组 医院感染 平均住院日 平均住院费用 

分 类 号：R195.1[医药卫生—卫生统计学]