Wakefield D S, Pfaller M A, Hammons G T, Massanari R M
Graduate Program in Hospital and Health Administration, University of Iowa, Iowa City 52242.
Med Care. 1987 Jun;25(6):481-8. doi: 10.1097/00005650-198706000-00003.
Existing methods for estimating additional days of hospital stay due to nosocomial infections (NI) have a number of documented limitations. An alternative method described in this paper uses the Appropriateness Evaluation Protocol (AEP) to determine whether each day of acute inpatient care is appropriate based on the need for care of the NI, original cause of hospitalization (OC), or combined NI-OC requirements. Using this method to identify specific days of hospitalization due to Staphylococcus aureus nosocomial infection, we find: 1) length of stay is increased for only a minority of patients (38%); 2) an average of 20 additional days of stay occurred for patients with 1 or more days attributed to NI; and 3) an average of 52% of length of stay of patients with 1 or more days attributed to NI can be attributed to the NI. Application of the AEP-based method is a useful alternative for identifying additional days of stay due to NI.
现有的估算因医院感染（NI）导致的额外住院天数的方法存在诸多已记录在案的局限性。本文所述的一种替代方法使用适宜性评估方案（AEP），根据对NI护理需求、住院原发病因（OC）或NI与OC综合需求，来确定急性住院护理的每一天是否适宜。使用该方法来确定因金黄色葡萄球菌医院感染导致的特定住院天数，我们发现：1）只有少数患者（38%）住院时间延长；2）归因于NI达1天或以上的患者平均多住院20天；3）归因于NI达1天或以上的患者，其住院时间平均有52%可归因于NI。基于AEP的方法在确定因NI导致的额外住院天数方面是一种有用的替代方法。
