【摘要】 目的比较颅脑手术后颅内感染与未感染患者的医疗费用支出,对颅脑手术部位感染(SSI)预防与控制项目的投入和产出进行成本效益分析。方法回顾性调查2014年6月—2015年5月某院神经外科所有颅脑手术患者,采用1∶1配比病例对照研究,比较颅脑手术后颅内感染与未感染患者的医疗费用,计算颅脑SSI的经济损失,分析神经外科SSI预防与控制项目的成本,并推算获得的收益。结果病例组住院时间为25(20,32)d,高于对照组的16(12,19)d,两组间差异具有统计学意义(P<0.001)。病例组住院总费用为96 150.6(69 415.0,153 079.6)元,高于对照组的59 438.6(50 092.6,77 336.4)元(P<0.001),居前5位的费用依次为西药费、手术费、治疗费、检查费、化验费,发生感染的患者各项费用均高于未感染患者。若实施神经外科SSI预防与控制项目,SSI发生率降低5%时,产生的经济效益足够支付项目的成本;当感染率降低20%~30%时,效益成本比可达到4~6。结论颅脑手术后颅内感染给患者带来沉重的经济负担。实施神经外科SSI医院感染预防与控制项目,不但可以减轻患者经济负担,增加医院收入,还可以提高医疗质量。更多还原

【Abstract】 Objective To compare medical expense of patients with and without intracranial infection after craniocerebral operation,analyze the cost-benefit of prevention and control programme for surgical site infection(SSI)after craniocerebral operation.Methods All patients who underwent craniocerebral operation in department of neurosurgery in a hospital between June 2014 and May 2015 were surveyed retrospectively,a1∶1 matched case-control study was adopted to compare medical expenses in patients with and without intracranial infection after craniocerebral operation,economic loss due to SSI after craniocerebral operation was calculated,cost of prevention and control programme for SSI was analyzed,benefit was calculated.Results Length of hospital stay in case group was longer than that of control group(25[20,32]d vs 16[12,19]d,P<0.001).Total hospitalization expense of case group was more than that of control group(96 150.6[69 415.0,153 079.6]yuan vs 59 438.6[50 092.6,77 336.4]yuan,P<0.001).The top5 expenses were fees for medicine,operation,therapy,examination,and laboratory testing,each expense of infected patients was higher than that of uninfected patients.If incidence of SSI decreased by 5% due to the implementation of SSI prevention and control programme in department of neurosurgery,the generated economic benefit was enough to pay the cost of programme;when infection rate decreased by20%-30%,the ratio of benefit to cost could reach4-6.Conclusion Intracranial infection after craniocerebral operation can bring a heavy economic burden to patients,implementation of prevention and control programme for SSI in department of neurosurgery can not only reduce the economic burden of patients,but also increase hospital income and improve medical quality.更多还原