目的 探究医院感染及其相关危险因素与按病种分值付费(diagnosis-intervention packet，DIP)结算差额的关联性。方法 选取2023年1—12月泰安市中医医院治疗的13584例医保出院患者进行回归性分析，了解患者的相关资料，进行多因素线性回归分析，分析医院感染及其相关危险因素对DIP结算差额的影响。结果 年龄、住院时间、营养不良、侵入性手术、抗菌药物、多重耐药菌(multi drug resistent organisms，MDRO)感染均为医院感染发生的影响因素(P<0。05);发生医院感染患者的DIP结算差额均较未发生感染患者高(P<0。05);营养不良、侵入性手术、抗菌药物、MDRO感染、年龄、住院时间均对DIP结算差额有一定的影响(P<0。05)。多因素分析显示，发生医院感染、存在营养不良、存在侵入性手术、使用抗菌药物、存在MDRO感染、年龄≥60岁、住院时间≥14 d，均为DIP结算差额的影响因素(P<0。05)。结论 医院感染及其相关危险因素与DIP结算差额之间存在一定的关联性，这一结果对于改善医院感染的预防和控制工作，以及优化医疗保险政策有着重要的指导意义。
The Association Between Nosocomial Infection and Its Related Risk Factors and Diagnosis-Intervention Packet Settlement Difference
Objective To explore the association between nosocomial infection and its related risk factors and diagnosis-intervention packet (DIP) settlement difference.Methods A total of 13584 discharged patients with medical insurance treated in Tai'an Traditional Chinese Medicine Hospital from January to December 2023 were selected for regression analysis.The relevant information of the patients was understood,and multivariate linear regression analysis were performed to analyze the impact of nosocomial infection and its related risk factors on DIP settlement difference.Results Age,length of stay,malnutrition,invasive surgery,antibiotics,and multi drug resistent organisms (MDRO) infection were influence factors for nosocomial infection (P<0.05).The DIP settlement difference of patients with nosocomial infection was higher than that of patients without infection (P<0.05).Malnutrition,invasive surgery,antibiotics,MDRO infection,age,and length of stay all had a certain impact on DIP settlement difference (P<0.05).Multivariate analysis showed that the occurrence of nosocomial infection,malnutrition,invasive surgery,antimicrobial use,MDRO infection,Age ≥ 60 years old,length of hospital stay ≥ 14 days were all factors influencing the difference of DIP settlement (P<0.05).Conclusion There is a certain correlation between nosocomial infection and its related risk factors and DIP settlement difference.The results have important guiding significance for improving the prevention and control of nosocomial infection and optimizing medical insurance policy.
nosocomial infectionrelated risk factorsdiagnosis-intervention packet settlement differencecorrelationagelength of stay
万方数据
维普
