医疗保险付费患者发生医院感染的经济损失及启示

目的通过分析医疗保险付费的脑梗塞、脑出血患者发生医院感染造成的直接经济损失及间接损失．探讨医疗保险付费制度下控制医院感染发生以增加经济效益和社会效益的必要性，并为医疗保险付费制度的制定提供一定的依据。方法采用回顾性调查方法，对34对医疗保险付费患者发生医院感染和未发生医院感染的病例进行病例对照研究。结果感染组与对照组相比，平均住院日延长7．5天，患者平均医疗总费用、药费、检查费、治疗费、平均自付费用均明显增加，两组差异有统计学意义（P〈0．01）。结论控制医院感染发生，可大大降低患者及社会的经济损失，节约有限的医疗资源，有助于合理的医疗保险付费制度的制定与实施。

Economic loss and enlightenment due to nosocomial infection of the patient paying by medical insurance

Objective Analyze the direct economic losses and indirect costs due to nosocomial infections to demon- strate that control nosocomial infections （NI） to increase economic returns and social effects is necessary in Chinese medical insurance system and provide us some evidences for the formulation of preferably medical insurance system. Methods All patients paying by medical insurance （34 with NI as case group, 34 without NI as control group） in pairs were investigated through case-control study retrospectively. Results The average bed-staytime of IN group exceeded that of control by 7.5 days and the average expenses in medical service in NI group was higher than that of control, there is a significant difference between two groups （P〈0.01）. Conclusion To decrease the nosocomial infection rate can reduce the economic loss of patients and society significantly, save the limited medical resource and make for the formulation and practice of reasonable medical insurance system.