四川某地市级医院基于DRG付费下医院感染医疗资源消耗分析
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R197.323.4

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四川省预防医学会医院感染预防与控制课题(SCGK202112)


Medical resource consumption of healthcare-associated infection based on disease diagnosis-related grouping payment model
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    摘要:

    目的 基于疾病诊断相关分组(DRG)付费模式,分析不同DRG分组患者发生医院感染的医疗资源消耗情况,为优化医院感染防控和资源管理提供依据。方法 回顾性分析四川省某地市级医院2024年1月1日—12月31日出院患者病案资料及DRG相关指标,比较医院感染组(院感组)与非医院感染组(非院感组)患者医疗资源消耗情况,分层分析两组患者平均住院日数及次均住院费用差异。结果 2024年该院纳入DRG管理的出院患者医院感染发病率为1.57%。院感组与非院感组患者在年龄、性别、入院及离院方式方面的差异均有统计学意义 (均P<0.05)。医院感染部位主要集中在下呼吸道、手术部位、泌尿道及血液。院感组时间消耗指数(1.63 VS 0.85)、平均住院日数(21.00 VS 5.00 d)、费用消耗指数(1.53 VS 0.92)、次均住院费用(4.47万 VS 0.73万)及多项费用均高于非院感组(均P<0.05)。血流感染医疗资源消耗较高。医院感染患者多集中在急性白血病伴严重并发症或合并症(MCC)相关分组,颅内或开颅手术伴MCC相关分组,气管切开伴机械通气96 h相关分组及胃、食道和十二指肠手术相关分组。重点DRG组中院感组患者平均住院日及次均住院费用均高于非院感组,差异均有统计学意义(均P<0.05)。结论 医院感染显著增加医疗资源消耗,基于DRG分组分析可进一步确定感染防控的重点病组,更加准确细化地评价医疗资源消耗情况,进而优化医疗资源配置,提升医院运营效率。

    Abstract:

    Objective To analyze the medical resource consumption of healthcare-associated infection (HAI) in patients in different groups of disease diagnosis-related grouping (DRG)based on the DRG payment model, provide reference for optimizing prevention and control of HAI as well as resource management. Methods Medical records and DRG-related indicators of discharged patients from a municipal hospital in Sichuan Province from January 1 to December 31, 2024 were analyzed retrospectively. Medical resource consumption of patients in HAI group and non-HAI group was compared. Differences in average length of hospital stay and average expense per hospitalization between two groups of patients were analyzed using stratified analysis. Results In 2024, HAI incidence of discharged patients in DRG management in this hospital was 1.57%. There were statistically significant differences in age, gender, admission and discharge ways between the HAI group and the non-HAI group (all P<0.05). The main HAI sites were lower respiratory tract, surgical site, urinary tract, and blood. The time consumption index (1.63 vs 0.85), average length of hospital stay (21.00 vs 5.00 days), expense consumption index (1.53 vs 0.92), ave-rage expense per hospitalization (44 700 vs 7 300), and multiple expense in HAI group were all higher than those in non-HAI group (all P<0.05). The consumption of medical resources for bloodstream infection was relatively higher. Patients with HAI were mostly concentrated in the groups related to acute leukemia with major complications or comorbidities (MCC), intracranial or craniotomy surgery with MCC, tracheotomy with mechanical ventilation for 96 hours, as well as gastric, esophageal, and duodenal surgery. The average length of hospital stay and average expense per hospitalization of patients in HAI group were both higher than those in the non-HAI group, differences were statistically significant (both P<0.05). Conclusion HAI significantly increase the consumption of medical resources. Based on DRG analysis, key disease groups for infection prevention and control can be further identified, and the consumption of medical resources can be more accurately and precisely evaluated, thereby optimizing the allocation of medical resources and improving hospital operational efficiency.

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江冬萍,杨森,马幸生,等.四川某地市级医院基于DRG付费下医院感染医疗资源消耗分析[J]. 中国感染控制杂志,2025,24(9):1286-1292. DOI:10.12138/j. issn.1671-9638.20252363.
JIANG Dongping, YANG Sen, MA Xingsheng, et al. Medical resource consumption of healthcare-associated infection based on disease diagnosis-related grouping payment model[J]. Chin J Infect Control, 2025,24(9):1286-1292. DOI:10.12138/j. issn.1671-9638.20252363.

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  • 收稿日期:2025-05-30
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  • 在线发布日期: 2025-09-23
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