OBJECTIVE  To evaluate the status of hospital-associated infections and their economic burden for patients in neurosurgery department based on Diagnosis Related Groups （DRG）.

METHODS  The study subjects were patients who were discharged under DRG settlement from the neurosurgery department of Jiangyin People's Hospital between 2023 and 2024. Their hospital-associated infection status was investigated, and direct and indirect economic burdens caused by hospital-associated infections were assessed with indicators such as length of hospital stay, hospitalization expenses, loss of medical revenue and loss of labor time.

RESULTS  A total of 2 059 patients were included, with a hospital-associated infection rate of 9.91% （204/2 059）. The lower respiratory tract was the primary site of infection （50.49%）. The average hospitalization expenses per case for infected patients in the AH29, BY15, BE25 and BB31 groups were 235 800 yuan, 28 000 yuan, 118 900 yuan and 71 000 yuan, respectively, all higher than those of non-infected patients （P＜0.05）. Among them, BB31 group had the highest infection rate （72.22%, 13/18）. AH29 group had the largest number of infection cases, with an infection rate of 48.44% （62/128）. AH29 group had the highest direct medical burden caused by hospital-associated infections, amounting to 2.1173 million yuan per year the patients with infections had higher expenses in medical treatment, medical technology, pharmaceutical and nursing categories than the non-infected patients （P＜0.05）. Patients with organ space infections had longer hospital stays and higher expenses than non-infected patients （P＜0.05）. AH29 group also had the most prominent indirect and hospital-level economic burdens caused by hospital-associated infections, with annual burdens of 422 300 yuan and 242 900 yuan, respectively.

CONCLUSIONS  The economic burden caused by hospital-associated infections in neurosurgery department is substantial, especially for patients with craniocerebral injuries complicated with tumors and those requiring invasive ventilator support. Quantifying the economic burden of infections based on DRG helps identify high-risk disease groups, implement stratified management, and actively intervene to reduce resource waste, thereby achieving multi-dimensional improvements in medical quality, economic efficiency and social benefits.