DRG付费背景下血液科患者医院感染情况及疾病经济负担

Prevalence of hospital-associated infections and economic burden of hematology department patients under DRG payment background

  • 摘要: 目的 基于疾病诊断相关分组(DRG)评估血液科患者医院感染现状及其经济负担。方法 以2023-2024年苏州大学附属第一医院血液科DRG结算出院患者为对象,回顾性分析其医院感染状况并采用住院日、住院费用、劳动时间损耗比较不同DRG组感染与非感染患者间的直接和间接经济负担。结果 共纳入患者4 590例次,医院感染发生率为5.32%。血液科感染病例重点分布在5个DRG组,感染部位以呼吸系统为主(44.71%)。所有DRG组感染组的住院日和费用均高于非感染组(P<0.05),药品类费用差异最大。AG19组感染发生率(33.20%)和患者住院费用最高(28.46万元); RB29组因医院感染造成的直接(148.33万元/年)和间接经济负担(15.33万元/年)最重。结论 血液科患者因医院感染承担着沉重的经济负担,尤其是异基因造血干细胞移植患者。基于DRG量化患者经济负担有利于医疗机构识别重点高风险病组并实现精准感控干预,以减少资源浪费,减轻患者负担,提升医疗质量和效果。

     

    Abstract: OBJECTIVE To evaluate the prevalence of hospital-associated infections (HAIs) among the hematology department patients and their economic burden based on diagnosis related groups (DRG). METHODS The patients who settled accounts based on DRG and were discharged from The First Affiliated Hospital of Soochow University between 2023 and 2024 were recruited as the research subjects, the prevalence of HAIs among the subjects was retrospectively analyzed; the direct and indirect economic burdens were compared between the patients with infections and the patients without infections among the different DRG groups by adopting the length of hospital stay, hospitalization costs and loss of labor time. RESULTS A total of 4 590 case-times of patients were enrolled in the study, with the incidence of HAIs 5.32%. The hematology department patients with infections mainly distributed in 5 DRG groups and the respiratory system (44.71%) was the major infection site. Among all the DRG group, the length of hospital stay was longer in the infection group than in the non-infection group, and the hospitalization cost of the infection group was more than that of the non-infection group (P<0.05); there was most significant difference in the cost of drugs. The incidence of infections was highest (33.20%) and the hospitalization cost was most (284,600 yuan) in the AG19 group; the direct economic burden (1,483, 300 yuan per year) and indirect economic burden (153,300 yuan per year) due to HAIs were greatest in the RB29 group. CONCLUSIONS The hematology department patients bear the heavy economic burden due to HAIs, the patients with the allogeneic hematopoietic stem cell transplantation patients in particularly. Quantizing the economic burden of the patients based on DRG may help the medical institution to identify the high-risk disease group and achieve the precise intervention to the infection control so as to reduce the wasting of resources, reduce the burden and improve the medial quality and effect.

     

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