Assessment of economic burden of allogeneic hematopoietic stem cell transplantation patients due to nosocomial infection based on CHS-DRG
OBJECTIVE To evaluate the direct economic burden of the allogeneic hematopoietic stem cell transplan-tation(allo-HSCT)patients due to nosocomial infection based on CHS-Diagnosis Related Groups(CHS-DRG).METHODS The data on the first page of medical records were collected from 8 healthcare institutions from 2014 to 2018 and were retrospectively analyzed and were grouped based on DRG.The length of hospital stay and hospitali-zation cost were compared between the patients with nosocomial infection and the patients without nosocomial in-fection.The direct economic burden due to the nosocomial infection was observed.RESULTS Among 3 831 allo-HSCT patients,2 322 were complicated with severe complications or AG11,the incidence of nosocomial infection was 18.91％,the median length of hospital stay was 60(40,82)days,the median hospitalization cost was 292 600(196 300,397 600)yuan.Totally 1 509 patients were not complicated with severe complications or AG15,the in-cidence of nosocomial infection was 13.52％,the median length of hospital stay was 39(31,50)days,the median hospitalization cost was 216 700(158 400,277 700)yuan.The hospitalization cost of the nosocomial infection group was more than that of the non-nosocomial infection group,the length of hospital stay of the nosocomial in-fection group was longer than that of the non-nosocomial infection group,the median difference value of the hospi-talization cost was 106 300 yuan,and the median difference value of the length of hospital stay was 15 days.CONCLUSION The incidence of postoperative nosocomial infection is high among the allo-HSCT patients,which brings heavy economic burden to both the patients and hospitals.As a high-risk and highly difficult treatment un-der the background of DRG,allo-HSCT is more likely to exceed the cost and leads to the loss of the hospital.It is necessary to establish a more thorough compensation mechanism and more precise grouping method so as to boost the enthusiasm for treatment of suspected and severe cases and benefit the patients.
Allogeneic hematopoietic stem cell transplantationDiagnosis related groupsNosocomial infectionEconomic burdenLength of hospital stayHospitalization costChina healthcare security diagnosis related groups
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