中国感染控制杂志2026，Vol.25Issue(6)：801-809,9.DOI:10.12138/j.issn.1671-9638.20263164
异基因造血干细胞移植患者医院感染的经济负担及DRG付费方式的调节作用
Economic burden of healthcare-associated infection in patients undergoing allogeneic hematopoietic stem cell transplantation and moderating effect of DRG payment methods
摘要
Abstract
Objective To assess the current status and economic burden of healthcare-associated infection(HAI)in patients undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT),and to explore the modera-ting role of diagnosis-related group(DRG)in HAI and hospitalization expense.Methods A retrospective study was conducted on patients who received allo-HSCT at the First Affiliated Hospital of Soochow University in 2024.Pro-pensity score matching was used to balance the confounding factors of HAI group(infection group)and non-HAI group(control group),and differences in length of hospital stay and hospitalization expense were compared between the two groups.A generalized linear model was used to analyze the impact of HAI,DRG payment methods and their interaction terms on hospitalization expense.Results A total of 587 patients were included in the analysis,and the incidence rate of HAI was 24.02%.After matching,139 pairs of patients were included.The average total hos-pitalization expense of patients in infection group was 282 100 Yuan,which was higher than the 256 300 Yuan for the control group(P<0.001),with the largest difference in drug expense at 17 600 Yuan.The main infection site was bloodstream.The economic burden caused by abdominal and digestive tract infection was the heaviest(with an average total hospitalization expense of 294 900 Yuan).Patients in DRG and non-DRG payment groups were balanced between groups in terms of length of hospital stay,age,etc.(all P>0.05).The moderating effect analy-sis revealed a significant interaction between DRG payment and HAI(β=-0.165,P=0.007),indicating that DRG could significantly reduce the impact of HAI on hospitalization expense.In non-DRG payment group,HAI resulted in a 24.0%increase in hospitalization expense;while in DRG payment group,the expense only increased by 5.1%.Conclusion The incidence of HAI in patients undergoing allo-HSCT is high,and the economic burden is heavy.The DRG payment method can effectively reduce the expense increase caused by HAI.关键词
医院感染/经济负担/疾病诊断相关分组/调节效应/异基因造血干细胞移植Key words
healthcare-associated infection/economic burden/diagnosis-related group/moderating effect/alloge-neic hematopoietic stem cell transplantation分类
医药卫生引用本文复制引用
王莹,金美娟,丁蔚,沈耀耀,伍志鹏,朱艳霞..异基因造血干细胞移植患者医院感染的经济负担及DRG付费方式的调节作用[J].中国感染控制杂志,2026,25(6):801-809,9.基金项目
国家自然科学基金面上项目(72574107) （72574107）
江苏省医院协会医院管理创新研究重点基金资助项目(JSYGY-2-2024-249) （JSYGY-2-2024-249）
江苏省医院协会医院管理创新研究基金资助项目(JSYGY-3-2023-111) （JSYGY-3-2023-111）
