Evaluation of economic burden of elderly ICU patients with respiratory system diseases due to hospital-associated CRE infections under CHS-DRG payment mode
10.11816/cn.ni.2025-258052
- VernacularTitle:CHS-DRG支付模式下ICU老年患者呼吸系统相关疾病CRE医院感染经济负担评价
- Author:
Yumu WANG
1
;
Weiqin YIN
;
Le YANG
Author Information
1. 常州市金坛第一人民医院医院感染与疾病预防控制科,江苏常州 213000
- Publication Type:Journal Article
- Keywords:
Chinese healthcare security diagnosis-related groups;
Payment;
Case mix index;
Respiratory system disease;
Carbapenem-resistant Enterobacter;
Hospital-associated infection;
Disease burden
- From:
Chinese Journal of Nosocomiology
2025;35(21):3216-3221
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the prevalence of hospital-associated carbapenem-resistant Enterobacter(CRE)infections among the elderly intensive care unit(ICU)patients with respiratory system diseases based on the Chinese healthcare security diagnosis-related groups(CHS-DRG)and the case mix index(CMI)and assess the economic burden and consumption of healthcare insurance funds.METHODS The key departments with high isola-tion rate of CRE and high incidence of hospital-associated infections were found out by using CMI.The data were collected from 56 elderly patients with major diagnostic category E(MDCE)who had hospital-associated Enter-obacter infection and were treated in 10 ICUs of the Second People's Hospital of Changzhou from 2021 to 2023.The length of hospital stay,economic burden and consumption of healthcare insurance funds were observed and compared between the CRE infection group and the carbapenem-sensitive Enterobacter(CSE)infection group.RESULTS The general ICU(Yanghu campus)ranked the top 3 isolation rate of CRE and incidence of hospital-associated in-fections after the adjustment of CMI value.EJ1(other respiratory system surgeries)and ES2(respiratory sys-tem infection/inflammation)were the core codes of major Enterobacter infection.The average length of hospital stay of the CRE group was 10 days larger than the CSE group,the self-funded amount was 20,777.65 yuan more in the CRE group than in the CSE group;the consumption of healthcare insurance funds was 39,631.64 yuan more in the CRE group than in the CSE group(P＜0.05).Of the patients encoded with ES2,the average length of hospital stay was 6.5 days more in the CRE group than in the CSE group,and the fund expense on pay-ment of severe diseases was greater in the CRE group than in the CSE group(P＜0.05).CONCLUSIONS The CRE infection may increase the length of hospital stay,economic burden and consumption of healthcare insurance funds of the elderly ICU patients with respiratory system diseases.Under the CHS-DRG payment mode,it is nec-essary to take targeted prevention and control strategies according to the characteristics of patients with different DRG codes so as to control the wide spread of CRE.
