OBJECTIVE To observe the impact of nosocomial infection under diagnosis related grouping (DRG)-based payment system on the consumption of hospital resources.

METHODS The patients who were hospitalized in a hospital from 2015 to 2020 were grouped based on CHS-DRG (V1.1). Descriptive statistical analysis and statistical test were performed for the consumption of resources of the infection group and the non-infection group by using time consumption index and cost consumption index.

RESULTS Of 463 529 cases that were enrolled in the study, 4 076 had nosocomial infection. The incidence of nosocomial infection was the highest among the AH11 patients (with invasive ventilator support no less than 96 hours, ECMO or total artificial heart transplantation, severe complications or comorbidities). The cost consumption index and time consumption index of the infection group (2.31, 2.24) were significantly higher than those of the non-infection group (0.96, 0.88) (P < 0.05). Pneumonia, sepsis and asymptomatic bacteriuria had the greatest impact on the consumption of resources. Among the three DRGs ES31 (respiratory system infection/inflammation, severe complications or comorbidities), AH11, BR23(cerebral ischemia, complications or comorbidities), the average length of hospital stay, time consumption index, average cost and cost consumption index of the infection group were higher than those of the non-infection group (P < 0.05). Among the types of costs, drug expense was the leading factor for high average cost of the infection group, which was dominated by cost of antibiotics.

CONCLUSION DRG may facilitate the determination of key disease group for prevention and control. Enhancement of the prevention and control of infection can effectively shorten the average length of hospital stay and reduce the average cost so as to improve the operation status of hospitals under DRG-based payment.