中山大学学报（医学科学版）2025，Vol.46Issue(2)：301-310,10.
ICU重症患者中心静脉导管相关血流感染的卫生经济学分析
Health Economic Analysis of Central Line-associated Bloodstream Infections in Critically Ill Patients in Intensive Care Unit
摘要
Abstract
[Objective]To explore the incremental cost of central line-associated bloodstream infections(CLABSI)after central venous catheterization(CVC)in critically ill patients in the intensive care unit(ICU),as well as the main cost of nosocomial infection prevention and control.By comparing these two costs,the medical personnel to pay more attention should CLABSI prevention and control from the perspectives of medical quality and economic benefits,and promote the implementation of prevention and control measures.[Methods]Cluster sampling was used to select 126 critically ill patients who underwent CVC in the ICU of a tertiary traditional Chinese medicine hospital from January 2021 to December 2023,including 65 cases in the CLABSI group and 61 in the non-CLABSI group.Patients'data were retrospectively collected from the hospital medical records,including the disease type,gender,age,length of hospital stay,outcome,and hospitalization expenses.The costs of different hand hygiene methods and differing approaches to environmental cleaning and disinfection were analyzed and compared.[Results]There were significant differences in the length of hospital stay(Z=-5.35,P<0.05)and total hospitalization expenses(Z=-6.79,P<0.05)between the CLABSI and non-CLABSI group.Total hospitalization expenses showed significant differences among patients with different lengths of hospital stay(H=43.01,P<0.05),with much higher median one in those with 60 or more days of hospital stay than other patients.Greater differences of median total hospitalization expenses were found in males than in females(Z=-3.98,P<0.05),as well as in patients aged 60-80 years than in patients of other ages(Z=-5.79,P<0.05).[Conclusions]The occurrence of CLABSI significantly increases the ICU patients'length of hospital stay and hospitalization expenses.There are differences in the costs of different hand hygiene methods and differing approaches to environmental cleaning and disinfection,but these costs are acceptable compared to the incremental costs directly attributable to CLABSI.Therefore,medical institutions should attach importance to the investment in prevention and control of nosocomial infections such as hand hygiene and environmental cleaning and disinfection,formulate practical,reasonable and feasible plans,and ensure their implementation,in order to avoid nosocomial infections,improve the medical quality,effectively control patients'length of hospital stay and hospitalization costs,and strive to maintain patient safety.关键词
重症监护室/中心静脉导管相关血流感染/住院费用/预防与控制/成本Key words
intensive care unit/central line-associated bloodstream infections/hospitalization expenses/prevention and control/cost分类
临床医学引用本文复制引用
蔡莉,冯晓敏,黄竞,陈惠超,李健,欧阳红莲..ICU重症患者中心静脉导管相关血流感染的卫生经济学分析[J].中山大学学报（医学科学版）,2025,46(2):301-310,10.基金项目
2022 年度广州市科技局-市校(院)联合资助项目(202201020315) （院）
2023 年度广东省中医药局中医药科研项目(20232049) （20232049）
