倾向指数匹配法在医院感染经济负担评价中的应用
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姜雪锦

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R181.3+2

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山东省医药卫生科技发展计划(2015WS0491,2017WS754)


Application of propensity score matching in the evaluation of economic burden of healthcareassociated infection
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    摘要:

    目的应用倾向指数匹配法(PSM)提高各协变量的均衡性,为医院感染经济负担评价提供新方法。方法选取某大型综合医院2015年1月1日—2016年12月31日出院的158 976例患者为研究对象,使用SPSS 22.0软件对医院感染患者和非医院感染患者进行1∶1的PSM匹配,采用匹配后的均衡数据库分析医院感染对患者住院天数和住院费用的影响。结果经PSM共成功匹配2 388对,匹配成功比率为97.75%,匹配后医院感染组和非医院感染组组间协变量各组比较,差异均无统计学意义(均P>0.05)。医院感染组和非医院感染组患者住院时间中位数分别为21、10 d,中位数差值为11 d,两组比较差异有统计学意义(P<0.05)。医院感染组和非医院感染组患者住院总费用中位数分别为33 618.38、15 004.93元,中位数差值为18 613.45元,两组比较差异有统计学意义(P<0.05)。除其他费用无统计学差异外,医院感染组床位费、西药费、中药费、治疗费、检查费、化验费、诊查费、护理费、输血费、手术费、材料费、麻醉费均高于非医院感染组(均P<0.05),其中两组间西药费差值最大,为6 987.00元。结论PSM结果显示医院感染造成了严重的经济负担,PSM可以为医院感染经济负担评价提供新方法。

     

    Abstract:

    ObjectiveTo improve the balance of each covariate using propensity score matching(PSM), provide a new method for evaluating economic burden of healthcare associated infection(HAI).Methods158 976 patients who were discharged from a large general hospital between January 1, 2015 and December 31, 2016 were selected as the studied subjects, a 1∶1 PSM matching of patients with HAI and without HAI was performed by SPSS 22.0 software, balanced database after matching was analyzed to evaluate the effect of HAI on patients’ length of hospital stay and hospitalization expense.ResultsA total of 2 388 pairs were successfully matched by using PSM, the successful matching rate was 97.75%, there was no statistical difference in covariates between HAI group and nonHAI group after matching (all P>0.05). The median of length of hospital stay in HAI group and nonHAI group were 21 and 10 days respectively, difference in median was 11 days, difference between two groups was statistically significant (P<0.05). The median of total hospitalization expenses in HAI group and nonHAI group were 33 618.38 and 15 004.93 Yuan respectively, difference in median was 18 613.45 Yuan, difference between two groups was statistically significant (P<0.05). Fees for bed, western medicine, traditional Chinese medicine, therapy, examination, laboratory testing, diagnostic check, nursing, blood transfusion, operation, material, and anesthesia in HAI group were all higher than nonHAI group (all P<0.05), difference in expense of western medicine was the largest, which was 6 987.00 Yuan, the other fees were not significantly different.ConclusionPSM results showed that HAI causes serious financial burden, PSM can provide a new method for evaluating the economic burden of HAI.

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引用本文

孙吉花,姜雪锦.倾向指数匹配法在医院感染经济负担评价中的应用[J]. 中国感染控制杂志,2018,17(9):797-800. DOI:10.3969/j. issn.1671-9638.2018.09.009.
SUN Jihua, JIANG Xuejin. Application of propensity score matching in the evaluation of economic burden of healthcareassociated infection[J]. Chin J Infect Control, 2018,17(9):797-800. DOI:10.3969/j. issn.1671-9638.2018.09.009.

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  • 收稿日期:2018-02-02
  • 最后修改日期:2018-04-12
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  • 在线发布日期: 2018-09-28
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