Morís de la Tassa J, Fernández Muñoz P, Antuña Egocheaga A, Gutiérrez del Río M C, de la Fuente García B, Cartón Sánchez J A
Servicio de Medicina Interna, Hospital de Cabueñes, Gijón.
Rev Clin Esp. 1998 Oct;198(10):641-6.
Nosocomial infection (NI) is associated with an increase in resource consumption. The estimation of extra costs attributable to NI in a group of patients with catheter-related bacteremia (CRB) was the objective of the present study.
A matched case-control, study was conducted in a cohort population. Individual matching was accomplished departing from the diagnosis related group (DRG) to which the case patient episode was ascribed and later searching in the hospital discharge data base using the following parameters: DRG, sex, age, admission date, department, comparison of hospital stays, main diagnosis, co-morbidity, number of secondary diagnoses and procedures. Matching was obtained for 22 cases (68.7%), upon which the cost estimations were performed.
The mean hospital stay length for cases was 26.5 days (median: 24.5) and for controls 14.5 days (median: 13.5), p = 0.0002. The excess stay attributable to CRB was 11.5 days. The use of diagnostic resources was significantly higher for bacteriological tests and complete blood counts. The consumption of antibiotics and fluid therapy was higher in infected patients. Eighty-nine percent of 536,736 pesetas, the total excess of the estimated cost per episode, corresponded to the increase in hospital stay length. Seven patients (32%) were responsible for 64% of the total of extra costs.
The method employed proved useful for estimating the costs associated with NI. The prolongation of hospital stay is responsible for most of the associated cost.
医院感染（NI）与资源消耗增加相关。本研究的目的是估计一组导管相关菌血症（CRB）患者中归因于NI的额外费用。
在队列人群中进行了一项匹配病例对照研究。个体匹配是从病例患者所归属的诊断相关组（DRG）开始，然后使用以下参数在医院出院数据库中进行搜索：DRG、性别、年龄、入院日期、科室、住院时间比较、主要诊断、合并症、次要诊断和手术数量。对22例病例（68.7%）进行了匹配，并在此基础上进行了成本估算。
病例组的平均住院时间为26.5天（中位数：24.5天），对照组为14.5天（中位数：13.5天），p = 0.0002。CRB导致的额外住院时间为11.5天。细菌学检查和全血细胞计数的诊断资源使用显著更高。感染患者的抗生素和液体疗法消耗量更高。每例估计成本总超额部分的536,736比塞塔中，89%与住院时间延长有关。7名患者（32%）承担了总额外费用的64%。
所采用的方法被证明有助于估计与NI相关的成本。住院时间延长是大部分相关成本的原因。
