基于疾病诊断相关分组管理的多重耐药菌患者疾病负担评价

Objective To assess the economic burden of patients with multidrug-resistant organisms(MDROs) under the Diagnosis-Related Groups(DRG) payment system. Methods A retrospective investigation was conducted on hospitalized patients admitted to a tertiary hospital from November 1, 2023, to October 30, 2024. Inclusion and exclusion criteria were established to compare differences in disease burden indicators—such as average length of stay, out-ofpocket expenses, average hospitalization costs, and mortality rates between MDROs patients and non-MDROs patients within the same disease subgroup. Results A total of 23,856 patients were included, among whom 242 had hospitalacquired MDROs, with 272 strains of multidrug-resistant bacteria identified, including 57 strains from hospital-acquired infections. The detection rate of MDROs was 0.23%. Once infected with MDROs, patients experienced an increase in average length of stay by 13.00 days, average hospitalization costs by ¥ 27,621.13, out-of-pocket expenses by ¥ 4,611.03, and mortality rate by 17.54 times(P<0.05). Among single MDROs infections, carbapenem-resistant acinetobacter baumannii(CRAB) detection was associated with the highest increases in out-of-pocket expenses, hospitalization costs, and mortality, while vancomycin-resistant enterococcus(VRE) detection led to the longest extension in hospitalization days. Patients with co-infections exhibited the highest values across all indicators—length of stay, out-of-pocket expenses, and hospitalization costs—compared to non-MDROs patients, with an average increase of 48.50 days in hospitalization, ¥ 113,364.45 in hospitalization costs, ¥ 12,751.96 in outof-pocket expenses, and a 35.61-fold increase in mortality. Conclusion Under the DRG payment system, MDROs patients significantly increased the disease burden in terms of average length of stay, out-of-pocket expenses, average hospitalization costs, and mortality rates.