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艰难梭菌感染治疗相关成本。

Costs Associated with the Treatment of Clostridioides Difficile Infections.

机构信息

Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland.

Laboratory of Epidemiology, Military Institute of Hygiene and Epidemiology (WIHE), 01-163 Warsaw, Poland.

出版信息

Int J Environ Res Public Health. 2021 Jul 19;18(14):7647. doi: 10.3390/ijerph18147647.

Abstract

BACKGROUND

, as the main cause of infectious diarrhoea in hospitalised patients, is a considerable challenge for medical personnel (hospital environment) who have direct contact with the patient, as well as being of interest to public health specialists. Financial issues related to the occurrence of the above-mentioned micro-organism are being increasingly raised. Due to the scale of the phenomenon, we are beginning to pay attention to the significant system costs caused by the diagnosis and treatment of CDI infection and its complications. Studies indicate that the nosocomial infection of complicates hospitalisation, by increasing the cost by more than half and extending patient's stay by an average of 3.6 days.

MATERIAL AND METHODS

The aim of this study was to attempt to calculate the estimated costs associated with the prolonged hospitalisation of patients with nosocomial CDI infection, using the example of a hospital in Lodz. A total of 53 completed hospitalisations of patients treated in the period of January-August 2018 were analysed, during which hospital infection was identified. For the purposes of this study, statistical data collected in the hospital's IT system were also analysed, covering 44,868 hospitalisations in the Jan-Aug 2018 period, during which no hospital infection occurred. They was a control group, in which the analysed cases were compared. The obtained data in the study determined how long each patient with infection stayed in the hospital (from the moment infection was diagnosed until the day of hospital discharge), and which diagnosis related groups (DRG) (according to National Health Fund guidelines) were assigned. The average length of patient stay without infection within a given DRG group in each hospital ward was also determined. The collected materials became the initial point for the final analysis of hospital costs and the length of hospital stay caused by infection.

RESULTS

infection extended the hospital stay by an average of almost 12 days. The average cost of prolonged hospitalisation due to CDI infection (according to the average cost per person-day) was about PLN 7148 (1664 EUR), which gave a total value of about PLN 378,860.6 (88,240.5 EUR) in the examined period. At the same time, the average expenditure from the National Health Fund for hospitalisation due to CDI infections increased by about PLN 6627 (1542.8 EUR), which in the analysed period translated into over PLN 351,232.0 (81,505.5 EUR) (according to settlements with the National Health Fund). The outcome indicates that there is a clear relation between CDI and the anticipated length of hospitalisation of patients without an infection.

摘要

背景

艰难梭菌是住院患者感染性腹泻的主要原因,对于直接接触患者的医务人员(医院环境)来说,这是一个相当大的挑战,同时也是公共卫生专家关注的问题。与上述微生物的发生有关的财务问题越来越受到重视。由于现象的规模,我们开始关注由 CDI 感染及其并发症的诊断和治疗引起的重大系统成本。研究表明,艰难梭菌的医院感染使住院时间延长,费用增加超过一半,患者平均住院时间延长 3.6 天。

材料和方法

本研究的目的是尝试使用 Lodz 医院的例子来计算与医院获得性 CDI 感染患者住院时间延长相关的估计费用。共分析了 2018 年 1 月至 8 月期间治疗的 53 例完成的住院患者,在此期间发现了医院感染。为了本研究的目的,还分析了医院 IT 系统中收集的统计数据,涵盖了 2018 年 1 月至 8 月期间 44868 例无医院感染的住院病例。有一个对照组,对分析病例进行了比较。研究中获得的数据确定了每位艰难梭菌感染患者的住院时间(从感染诊断到出院日),并确定了哪些诊断相关组(DRG)(根据国家卫生基金指南)被分配。还确定了每个特定医院病房中无感染患者在给定 DRG 组内的平均住院时间。收集的材料成为最终分析医院成本和艰难梭菌感染导致的住院时间的起点。

结果

艰难梭菌感染使住院时间平均延长了近 12 天。艰难梭菌感染(按人均日费用计算)导致的延长住院治疗费用平均约为 7148 波兰兹罗提(1664 欧元),这在研究期间总计约为 378860.6 波兰兹罗提(88240.5 欧元)。同时,由于艰难梭菌感染导致的住院治疗,国家卫生基金的平均支出增加了约 6627 波兰兹罗提(1542.8 欧元),这在分析期间转化为超过 351232.0 波兰兹罗提(81505.5 欧元)(根据与国家卫生基金的结算)。结果表明,艰难梭菌与无感染患者预期住院时间之间存在明显关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/022a/8307892/8cdaa04dafb0/ijerph-18-07647-g001.jpg

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