OBJECTIVE To analyze the prevalence of hospital-associated multidrug-resistant organisms (MDROs) infections based on diagnosis-related groups (DRGs) and observe the direct economic burden.

METHODS The patients who were performed with DRGs and discharged from Tianjin First Central Hospital from Jan. 1, 2023 to Dec. 31, 2023 were enrolled in the study, and the prevalence of hospital-associated MDROs infections among the patients was retrospectively analyzed. Among the DRGs, the average length of hospital stay, hospitalization costs and antimicrobial use density (AUD) were observed and compared between the MDRO infection group and the non-MDROs infection group. The direct economic burden due to the infections was analyzed.

RESULTS A total of 82, 303 case-times of discharged patients were valid for DRGs, 113 (0.13%) of which had hospital-associated MDROs infections. The patients who had respiratory system infections were dominant among the patients with various sites of infections. Carbapenem-resistant Enterobacteriaceae was the predominant pathogen, accounting for 50.86%. The case-time infection rate of MDROs was highest (0.54%) in hematology department after the adjustment with case-mix index (CMI); the case-times number of infections was largest (13 case-times) in RB11 group, the case-time infection rate was the highest (11.39%) in the AB11 group. In the RB11 group, the average length of hospital stay, hospitalization costs, medical costs, western medicine costs, antibiotics costs and AUD were higher in the MDROs infection group than in the non-MDROs infection group (P < 0.05).

CONCLUSION The DRGs management system may assist the identification of key groups for prevention and control of MDROs infections and push forward the standardized use of antibiotics through precise control and prevention strategies for MDROs infections so as to effectively shorten the average length of hospital stay, reduce the hospitalization costs and improve the medical quality under DRGs payment.