神经外科脑肿瘤切除患者医院感染成本分析

Cost analysis of hospital-acquired infections in neurosurgery department patients undergoing brain tumor resection

  • 摘要:
    目的 分析神经外科脑肿瘤切除患者医院感染率及经济成本,为制定医院感染管理策略提供科学依据。
    方法 选取山东第一医科大学第一附属医院神经外科2020年1月1日-2024年12月31日行脑肿瘤切除手术的患者1 027例为研究对象,术后发生医院感染患者36例为感染组,未发生医院感染患者991例为未感染组,采用倾向指数匹配法(卡钳值0.005)1∶1匹配感染组与未感染组患者,比较感染组和未感染组住院天数和各项医疗费用,估算医院感染造成的经济负担。
    结果 脑肿瘤切除患者医院感染率为3.51%,倾向性评分匹配成功36对。匹配后感染组住院费用109 103.81 (73 370.21, 163 628.37)(元)较未感染组费用增加50 087.69元(Z=-5.237, P < 0.001),住院天数23.00(17.25, 36.00) d延长8.50 d(Z=-3.764, P < 0.001)。在各项费用中,费用中位数增加最多的是西药费、治疗材料费和实验室诊断费。
    结论 控制西药、治疗材料及实验室诊断费用是降低脑肿瘤切除患者医院感染成本的关键。针对医院感染进行实时监控,对疑似病例及时预警,降低医院感染率,为降低经济成本的重要策略。

     

    Abstract:
    OBJECTIVE To investigate the incidence of hospital-associated infections among the neurosurgery department patients undergoing brain tumor resection and analyze the economic cost so as to provide scientific bases for formulating prevention strategies.
    METHODS Totally 1027 patients who underwent brain tumor resection in neurosurgery department of the First Affiliated Hospital of Shandong First Medical University from Jan. 1, 2020 to Dec. 31, 2024 were recruited as the research subjects. The 36 patients who had postoperative hospital-associated infections were assigned as the infection group, and 991 patients who did not have hospital-associated infection were assigned as the no infection group. The patients of the infection group and the non-infection group were matched in a 1∶1 ratio by using propensity score matching method (caliper value 0.005). The length of hospital stay and costs of medical items were compared between the infection group and the non-infection group, and the economic burden due to the hospital-associated infections was estimated.
    RESULTS The incidence of hospital-associated infections was 3.51% among the patients undergoing brain tumor resection, and totally 36 pairs were matched successfully with the propensity score. The hospitalization cost of the infection group was 109, 103.81 (73, 370.21, 163, 628.37) yuan after the matching, which was increased by 50, 087.69 yuan as compared with the non-infection group (Z=-5.237, P < 0.001); the length of hospital stay was 23.00 (17.25, 36.00) days, which was prolonged by 8.50 days (Z=-3.764, P < 0.001). Among the costs of medical items, the medial costs of western medicine, treatment materials and clinical laboratory tests increased most.
    CONCLUSIONS The control of the costs of western medicine, treatment materials and clinical laboratory tests is the key to reduce the costs of brain tumor resection patients with hospital-associated infections. It is necessary to carry out the real-time monitoring of the hospital-associated infections and early warning of suspected cases and reduce the incidence of hospital-associated infections so as to reduce the economic costs.

     

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