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耐甲氧西林对住院时间、再入院率和费用的影响:基于挪威住院患者登记的病例对照研究。

The impact of methicillin-resistant on length of stay, readmissions and costs: a register based case-control study of patients hospitalized in Norway.

作者信息

Andreassen A Elizabeth S, Jacobsen Caroline M, de Blasio BirgitteFreiesleben, White Richard, Kristiansen Ivar Sønbø, Elstrøm Petter

机构信息

Norwegian Institute of Public Health, Marcus Thranesgate 2, 0473 Oslo, Norway.

Department of Antibiotic resistance and Infection control, Norwegian Institute of Public Health, Oslo, Norway.

出版信息

Antimicrob Resist Infect Control. 2017 Jul 6;6:74. doi: 10.1186/s13756-017-0232-x. eCollection 2017.

Abstract

BACKGROUND

Patients with methicillin-resistant (MRSA) are thought to incur additional costs for hospitals due to longer stay and contact isolation. The aim of this study was to assess the costs associated with MRSA in Norwegian hospitals.

METHODS

Analyses were based on data fromSouth-Eastern Norway for the year 2012 as registered in the Norwegian Surveillance System for Communicable Diseases and the Norwegian Patient Registry. We used a matched case-control method to compare MRSA diagnosed inpatients with non-MRSA inpatients in terms of length of stay, readmissions within 30 days from discharge, as well as the Diagnosis-Related Group (DRG) based costs.

RESULTS

Norwegian patients with MRSA stayed on average 8 days longer in hospital than controls, corresponding to a ratio of mean duration of 2.08 (CI 95%, 1.75-2.47) times longer.A total of 14% of MRSA positive inpatients were readmitted compared to 10% among controls. However, the risk of readmission was not significantly higher for patients with MRSA. DRG based hospital costs were 0.37 (95% CI, 0.19-0.54) times higher among cases than controls, with a mean cost of EUR13,233(SD 26,899) and EUR7198(SD 18,159) respectively.

CONCLUSION

The results of this study indicate that Norwegian patients with MRSA have longer hospital stays, and higher costs than those without MRSA.

摘要

背景

耐甲氧西林金黄色葡萄球菌(MRSA)感染患者被认为会因住院时间延长和接触隔离而给医院带来额外成本。本研究旨在评估挪威医院中与MRSA相关的成本。

方法

分析基于2012年挪威东南部在挪威传染病监测系统和挪威患者登记处登记的数据。我们采用匹配病例对照方法,比较确诊为MRSA的住院患者与非MRSA住院患者在住院时间、出院后30天内再入院情况以及基于诊断相关分组(DRG)的成本方面的差异。

结果

挪威MRSA感染患者的平均住院时间比对照组长8天,平均住院时间之比为2.08(95%置信区间,1.75 - 2.47)倍。MRSA阳性住院患者的再入院率为14%,而对照组为10%。然而,MRSA感染患者的再入院风险并未显著更高。基于DRG的医院成本,病例组比对照组高0.37(95%置信区间,0.19 - 0.54)倍,平均成本分别为13233欧元(标准差26899)和7198欧元(标准差18159)。

结论

本研究结果表明,挪威MRSA感染患者的住院时间更长,成本也高于非MRSA感染患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b76/5501579/e071690d2d9d/13756_2017_232_Fig1_HTML.jpg

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