Yu Lv1, Lan Chen2, Wu Yu J3, Qian Xiang4, Qiong S Tang5, Feng D Wang6, Hong M Cai7, Kun Zou8, Qiong D Wei9, Hua Z Zhou10, Hui Wang11, Chen Wang12, Jing Chen13, Ting L Li14, Ying Fang15, Huan Wang16. 1. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 29381636@qq.com. 2. Chengdu Food and Drug Inspection and Research Institute, Chengdu, 610045, Sichuan, PR China. Electronic address: jump_crstal@163.com. 3. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: wujy1115@163.com. 4. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 3all@163.com. 5. Public Health Department, Tongxi Center Health Hospital, Hechuan, 401520, Chongqing, PR China. Electronic address: 2105044700@qq.com. 6. Department of Nursing, Nanjin Street Social Health Service Center, Hechuan, 401520, Chongqing, PR China. Electronic address: 1049727080@qq.com. 7. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 26857276@qq.com. 8. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: zoukun.jy@outlook.com. 9. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 1536382101@qq.com. 10. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 545208705@qq.com. 11. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 1139181198@qq.com. 12. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 534127551@qq.com. 13. Healthcare-associated Infection Management Office, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, 610072, Sichuan, PR China. Electronic address: 315509827@qq.com. 14. Development Department, Chengdu Yiou Technology Co. Ltd., Chengdu, 610000, Sichuan, PR China. Electronic address: 452376426@qq.com. 15. Healthcare-associated Infection Management Division, Jianyang People's Hospital, Jianyang, 641400, Sichuan, PR China. Electronic address: 1135531579@qq.com. 16. Healthcare-associated Infection Management Office, Yibin Second People's Hospital, Yibin, 644000, Sichuan, PR China. Electronic address: 515254058@qq.com.
Abstract
BACKGROUND: In 2018, diagnosis-related group-based prospective payment system (DRG-PPS) was implemented nationwide by China that did not fully consider the additional costs caused by healthcare-associated infections (HAIs). HAIs can increase hospitalization costs, but only a few studies have been conducted in China. We aimed to assess the additional costs caused by HAIs. METHODS: A retrospective matched case-control (1:1) study was performed in one of the largest tertiary hospitals in Sichuan Province, China. A multiple linear regression was used to identify confounding factors, and the propensity score matching (PSM) method was used to balance confounding factors between cases and controls. On this basis, we estimated the additional costs caused by HAIs. RESULTS: Of the 109,294 inpatients observed, 1912 had HAI. After the PSM method was implemented, 1686 cases were successfully matched. Median hospitalization costs were €5613.03 for patients with HAIs and €3414.83 for patients without HAIs (P < 0.001), resulting in an absolute difference of €2198.19. With the exception of pathological diagnosis costs, surgical treatment costs and disposable medical material costs for surgery, all other types of costs for the cases with HAIs were larger. CONCLUSIONS: Patients with HAIs incurred greater hospitalization costs than non-HAI patients, which warrants closer attention if we are to reform the payment method of medical insurance in China.
BACKGROUND: In 2018, diagnosis-related group-based prospective payment system (DRG-PPS) was implemented nationwide by China that did not fully consider the additional costs caused by healthcare-associated infections (HAIs). HAIs can increase hospitalization costs, but only a few studies have been conducted in China. We aimed to assess the additional costs caused by HAIs. METHODS: A retrospective matched case-control (1:1) study was performed in one of the largest tertiary hospitals in Sichuan Province, China. A multiple linear regression was used to identify confounding factors, and the propensity score matching (PSM) method was used to balance confounding factors between cases and controls. On this basis, we estimated the additional costs caused by HAIs. RESULTS: Of the 109,294 inpatients observed, 1912 had HAI. After the PSM method was implemented, 1686 cases were successfully matched. Median hospitalization costs were €5613.03 for patients with HAIs and €3414.83 for patients without HAIs (P < 0.001), resulting in an absolute difference of €2198.19. With the exception of pathological diagnosis costs, surgical treatment costs and disposable medical material costs for surgery, all other types of costs for the cases with HAIs were larger. CONCLUSIONS:Patients with HAIs incurred greater hospitalization costs than non-HAI patients, which warrants closer attention if we are to reform the payment method of medical insurance in China.
Authors: Nicolas Calcagni; Anne-Gaëlle Venier; Raymond Nasso; Guillaume Broc; Eva Ardichen; Bruno Jarrige; Pierre Parneix; Bruno Quintard Journal: Infect Prev Pract Date: 2021-08-14