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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (10): 89-95.doi: 10.6040/j.issn.1671-7554.0.2021.0653

• 临床医学 • 上一篇    下一篇

神经外科患者医院感染经济负担和住院时间分析

刘雪燕1,王光鹏2,姚雪1,卢冉冉1,王书会3   

  1. 1.山东大学齐鲁医学院护理与康复学院, 山东 济南 250012;2.中南大学湘雅护理学院, 湖南 长沙 410012;3.山东大学齐鲁医院医院感染管理科, 山东 济南 250012
  • 发布日期:2021-10-15
  • 通讯作者: 王书会. E-mail:wangshqlyy@163.com

Analysis of economic burden and length of hospital stay of nosocomial infection in neurosurgery patients

LIU Xueyan1, WANG Guangpeng2, YAO Xue1, LU Ranran1, WANG Shuhui3   

  1. 1. School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Xiangya Nursing School, Central South University, Changsha 410012, Hunan, China;
    3. Department of Infection Management, Qilu Hospital, Shandong University, Jinan 250012, Shandong, China
  • Published:2021-10-15

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摘要： 目的 探讨神经外科术后医院感染给患者带来的直接经济负担及对住院时间的影响,以期为制定相关防控措施提供经济学参考依据。 方法 回顾性收集2020年1月1日至12月31日在山东省某三甲医院神经外科接受手术治疗的1 487例患者为研究对象。将患者分为医院感染组和非医院感染组,采用1∶1倾向性评分匹配法(卡钳值为0.02,采用不放回抽样)及Wilcoxon秩和检验分析两组患者的直接经济负担及住院时间。 结果 (1) 共有228例患者发生医院感染,感染率为15.33%,倾向性评分匹配成功228对。(2) 匹配前,非医院感染组和医院感染组中位住院总费用分别是50 971.40元和65 739.67元,中位住院时间分别是17、23 d。(3) 匹配后,非医院感染组中位住院总费用是52 177.10元,医院感染组是65 739.67元,总的直接经济负担是13 562.57元,其他各项医疗费用也均高于非医院感染组,且以西药费增加最多,差异有统计学意义(Z=-16.864, P<0.001)。(4) 非医院感染组中位住院时间是17 d,而医院感染组是24 d,比非医院感染组延长7 d(Z=-11.532, P<0.001)。(5) 住院总费用、床位费、诊疗费、检查费、治疗费、化验费、护理费、西药费、卫生材料费在所有的医院感染类型中存在统计学差异(P<0.05),而手术费和住院时间在医院感染类型中无统计学差异(P>0.05),并且以手术部位感染合并肺部感染患者的住院总费用最高。 结论 神经外科术后医院感染率较高,延长了患者住院时间,并加重了患者经济负担,且以多部位感染患者的损失最重。医院感染管理者应制定有效方案预防医院感染,以改善患者预后,减轻住院经济负担,提高医疗资源利用率。

关键词: 神经外科, 医院感染, 经济负担, 住院时间

Abstract: Objective To explore the direct economic burden of nosocomial infections in patients after neurosurgery and the impact on the length of hospital stay, in order to provide an economic reference for the formulation of relevant prevention and control measures. Methods A total of 1,487 patients who underwent surgical treatment in the neurosurgery department of a tertiary hospital in Shandong Province during Jan. 1 and Dec. 31, 2020 were enrolled. The patients were divided into the infection group and non-infection group. The direct financial burden and length of hospital stay of patients were analyzed with 1∶1 propensity score matching method(caliper value was 0.02, non-replacer sampling was used)and Wilcoxon rank-sum test. Results Nosocomial infections occurred in 228 patients, the infection rate was 15.33%, and the propensity score matched 228 pairs successfully. Before matching, the median hospitalization costs of the non-infection group and infection group were 50 971.40 yuan and 65 739.67 yuan, respectively, and the median hospitalization time was 17 days and 23 days, respectively. After matching, the median hospitalization costs were 52 177.10 yuan in the non-infection group, and 65 739.67 yuan in the infection group, which was 13 562.57 yuan higher. Other medical expenses were also higher in the infection group, especially the costs of Western medicine(Z=-16.864, P<0.001). The length of hospital stay was 17 days in the non-infection group, and 24 days in the infection group, which was 7 days longer(Z=-11.532, P<0.001). The total hospitalization costs, bed fees, diagnosis and treatment fees, examination fees, treatment fees, laboratory tests fees, nursing fees, Western medicine fees, and sanitary materials fees were statistically different among all types of hospital infections(P<0.05). However, there was no significant difference in operating expenses and length of hospital stay(P>0.05). The total hospitalization costs were the highest in patients with surgical site infection and lung infection. Conclusion The rate of nosocomial infection after neurosurgery is relatively high, which prolongs the length of hospital stay and increases the economic burden on patients. In addition, patients with multiple infections suffer the most. Nosocomial infection managers should formulate effective plans to prevent nosocomial infections to improve the prognosis of patients, reduce the economic burden of hospitalization, and increase the utilization of medical resources.

Key words: Neurosurgery, Hospital infection, Economic burden, Length of hospital stay

中图分类号: 

  • R651.1
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