【摘要】 目的探讨医院骨科手术部位发生医院感染所造成的直接经济损失。方法选取2011—2013年某三级甲等综合医院骨科住院手术患者为研究对象,排除其他部位感染,仅有手术部位感染患者47例为感染组,选取同期骨科住院手术,未发生手术部位感染患者为对照组,进行1∶1配对,有45例成功配对。感染组与对照组调查方法完全一致,考虑骨科手术进口与国产材料器械的价格差影响,在患者治疗费用调查中,本研究排除植入物器械费用部分,调查床位费、药费、检查、诊疗费、手术费、检验费及其他费用。结果感染组术后住院天数中位数34 d,对照组16 d,感染组住院天数延长18 d。两组术后住院天数比较,差异有统计学意义(P<0.05)。骨科手术扣除植入物费用,感染组总费用中位数43 380元,对照组21 009元,感染组总费用是对照组的2.06倍,感染患者人均多支出22 371元,感染组平均药费13 078元,对照组平均药费4 495元,多支出药费8 581元。感染组与对照组各种费用比较,差异有统计学意义(P<0.05)。无植入物感染组术后住院天数较对照组延长11 d,总费用多支出5 272元,其中药费多支出3 705元。带植入物感染组术后住院天数延长24 d,总费用多支出23 544元,其中药费多支出9 644元。感染组与对照组各种费用比较,差异有统计学意义(P<0.05)。结论骨科手术部位发生医院感染延长术后住院时间,增加医疗费用,造成巨大的经济损失。更多还原

【Abstract】 Objective To investigate the direct economic loss caused by nosocomial infection of surgical site after orthopedic surgery. Methods Patients from orthopedics of Yixing People’ s Hospital were selected from 2011 to 2013. Forty-seven cases of surgical site infection were selected as the infection group,excluding other sites infection. Forty-five none-infection patients from orthopedics were included as the control group at the corresponding period. The survey method is the same between the two groups. Considering the effect of the price difference between imported and domestic materials,we excluded the cost of implant equipment, investigates bed expenses, medical expenses, inspection expenses, medical expenses, operation expenses and other expenses. Results The median post-operative hospitalization time of the infection group were significantly longer than that of the control group( 34 versus 16 days),( P < 0. 05). The median total cost of the infection group was 43 380 yuan,2. 06 times significantly more than that of the control group( 21 009 yuan). The average medicine cost of the infection group was 13 078 yuan,8 851 yuan significantly more than that of the control group( 4 495 yuan),( P < 0. 05). The median post-operative hospitalization time of the none-implant infection group was 11 days more than that of the control group. The total cost of the none-implant infection group was 5 272 yuan more than that of the control group. The medicine cost of the none-implant infection group was 3 705 yuan more than that of the control group( P < 0. 05). The median post-operative hospitalization time of the implant infection group was 24 days more than that of the control group. The total cost of the implant infection group was 23 544 yuan more than that of the control group. The medicine cost of the implant infection group was 9 644 yuan more than that of the control group( P < 0. 05). Conclusion Orthopedics surgical site infection significantly extends the post-operative hospitalization time and increases medical cost,and causes enormous economic losses.更多还原