摘要
目的测算某大型综合医院高龄患者医院感染额外费用、住院天数、死亡率,为提高高龄患者医院感染管理水平提供数据支持。方法回顾性分析某医院2012年1月1日~2015年1月1日期间≥80岁的高龄住院患者资料,并用SPSS软件的PSM（倾向指数匹配法）对感染组和非感染组进行1：1匹配,得到组间协变量均衡的样本,并用SPSS19.0软件对新样本组间的额外费用、住院天数、死亡率进行统计分析。结果两组共成功匹配836对,感染组平均住院日中位数为31.0d,非感染组中位数为15.0d,差值中位数为16.0d（Z=-20.92,P〈0.01）。感染组住院总费用中位数为101 912.9元,非感染组中位数为43 110.2元,差值中位数为58 802.7元（Z=-17.59,P〈0.01）。日均感染费用为3 675.2元。增加的费用前四位依次为西药费30 084.7元、治疗费10 391.6元、化验费7 347.3元、材料费6 477.8元,占总费用的92.3%。感染组的死亡率为21.5%,非感染组的死亡率为16.6%,差值为4.9%（P〈0.001）。结论 PSM测算结果提示,高龄患者医院感染危害大,是医院感染的极高危人群,必须高度重视,需加强目标性监测,并采取有效措施努力降低医院感染发生率。
Objective To accurately measure the additional direct economic loss, average length of hospital stay and mortality of elderly patients with nosocomial infection in a large general hospital, so as to provide the basis for improving maqnagement of nosocomial infection in the elderly patients. Methods Retrospective analysis of nosocomial infection in the elderly patents over 80 years in a large general hospital during January 2012 to 2014 was conducted.The patients with nosocomial infection and without nosocomial infection were matched with a ratios of 1：1 to get covariate equilibrium between group samples by using SPSS PSM, SPSS19.0 software was applied for statistical analysis. Results Eight hundred and thirty- six pairs were successfully matched in total. Median average hospital stay of the patients with nosocomial infection and control group were 31.0 days and 15.0 days, respectively, with median difference of 16.0 days（P〈0.01 ）. Median hospitalization cost in patients of nosocomial infection group was RMB101 912.9, while that in the control group, was RMB 43 110.2, with median difference of RMB 58 802.74（P〈0.01 ）.The average daily infection cost was RMB 3 675.2. The top 4 additional cost items were RMB 30 084.7 for medicine, RMB 10 391.6 for treatment, RMB 7347.3 for tests, and RMB 6 477.8 for materials, which accounted for 92.3% of the total cost. Besides, the mortality rate increased in elderly patients with nosocomial infection. Conclusion Hospital infection is harmful to the health of the elderly patients who are at high risk of nosocomial infection. Thus special attention be paid to the health of the elderly patients, and key indicators should be monitored intensively and effective measures be taken to reduce the incidence of nosocomial infection.
出处
《中国热带医学》
CAS
2015年第6期723-727,共5页
China Tropical Medicine
基金
全军医学科学技术研究"十二五"计划保健专项课题(No.11BJZ01)
关键词
倾向指数匹配法
高龄患者
医院感染
直接经济损失
死亡率
Propensity score matching
Elderly patients
Nosocomial infection
The direct economic loss
Mortality
