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目的调查血液透析住院患者因医院感染所造成的经济负担,为降低血液透析患者医院感染发生率,减少其经济负担提供科学依据。方法采用病例对照研究方法,调查2008年1月1日-2012年12月31日医院血液透析病房进行血液透析的尿毒症患者共1115例,发生医院感染122例为感染组,未发生医院感染993例为对照组,比较两组住院费用和住院天数的差异。结果感染组患者的住院总费用中位数为32 269元,对照组为14872元,两组患者住院总费用中位数差值为17 397元,差异有统计学意义(P<0.05);感染组患者住院天数中位数为41d;对照组为25d,两组患者中位数差值为16d,差异有统计学意义(P<0.05);感染组与对照组患者在床位费、诊疗费、检查费、治疗费、化验费、护理费、药物费和其他费用的中位数差值比较差距较大,差异有统计学意义(P<0.05),经济负担最多的住院费用为西药费占49.31%,其次为治疗费占33.14%,经济负担最少的是诊疗费占0.33%。结论血液透析住院患者发生医院感染后造成的经济负担较未发生医院感染的血液透析住院患者重,应采取有效措施,降低血液透析患者医院感染发生率,减少因医院感染造成的经济负担。
Objective To investigate the economic burden of inpatients with hemodialysis due to nosocomial infection and to provide a scientific basis for reducing the incidence of nosocomial infection and the economic burden of hemodialysis patients. Methods A case-control study was conducted to investigate the prevalence of 1115 cases of hemodialysis in hospital hemodialysis ward from January 1, 2008 to December 31, 2012. 122 cases of nosocomial infection were infected and no nosocomial infection occurred 993 Cases for the control group, the difference between hospitalization costs and hospital days were compared. Results The median total cost of hospitalization was 32 269 yuan in infection group and 14872 yuan in control group. The median difference of total cost of hospitalization between the two groups was 17 397 yuan (P 0. 05). The infection The median hospitalization days were 41 days in the control group and 25 days in the control group, with a difference of 16 days between the two groups (P <0.05). In the infection group and the control group, The median difference of inspection fee, treatment fee, laboratory fee, nursing fee, drug fee and other expenses was relatively large, with significant difference (P <0.05). The hospitalization cost with the most economic burden was Western medicine expense accounting for 49.31 %, Followed by treatment costs accounted for 33.14%, the least economic burden is the treatment fee accounted for 0.33%. Conclusion The economic burden caused by nosocomial infection in hemodialysis patients is more serious than that in hemodialysis patients without nosocomial infection. Effective measures should be taken to reduce the incidence of nosocomial infection in hemodialysis patients and the economic burden caused by nosocomial infections.