Study On The Risk Factors And Direct Economic Losses Of Nosocomial Infection With Type 2 Diabetic

ObjectiveTo estimate conditions and risk factors of nosocomial infection among patients with type 2 diabetes mellitus. Evaluating the direct economic losses caused by hospital infection through analyzing the hospitalized cost and the length of stay (LOS) so as to supply scientific foundation for medical administrative departments to develop relevant principles.MethodsUsing of cluster sampling methods,817 type 2 diabetes mellitus patients admitted to endocrine department of a tertiary teaching hospital in Shandong during the year of 2015 were chosen. Two contents were researched.1. Study of risk factors:all patients were monitored and then filled in the self-designed forms. Two people entered the data to SPSS 17.0. Characteristic information was described with mean and standard deviation, prevalence, proportions and etc. Between-group differences were used chi-square test and t test. Logistic regression analysis was used to analyze the risk factors of hospital infection.2. Direct economic losses:patients with nosocomial infection were described as case group and those without were control group. Hospitalization expenses and LOS between the two groups were compared after 1:1 pairing. Median was used to describe average hospitalized costs and hospitalization time. Difference between groups was used rank sum test.Results1.817 Type 2 diabetes mellitus were included in our study and 80 patients suffered from nosocomial infection with a prevalence of 9.80%.2. The number of patients with urinary tract infection was the most and accounted for 34.11%, then followed by the lower respiratory tract infection and the upper respiratory tract which both accounted for 28.24%.3.35 strains of pathogenic bacteria were detected from 45 patients.10 strains were Gram-positive bacteria (28.57%) and the most was Streptococcus viridians; 23 strains were Gram-negative bacteria (65.71%) and the most was Escherichia coli; 2 strains of fungi were detected (5.71%).4. Nosocomial infection on type 2 diabetes mellitus was associated with gender, age, admission time, hospitalization days, fasting blood glucose, total cholesterol levels, nutritional status, fasting blood glucose, albumin, glycosylated hemoglobin, motor nerve conduction velocity, basic diseases, blood pressure levels, complications and course of disease (P<0.05). Gender, age, admission time, hospitalization days, nutritional status, fasting blood glucose, motor nerve conduction velocity and course of disease were dependent risk factors of nosocomial infection.5. The total hospitalization cost in case group was significantly higher than that in control group. The case group was 8 891 yuan and control group was 6155yuan. The direct economic loss was 2 736yuan. Cost of drugs was largest in case group with 4 279yuan, accounted for 50.95%, and secondly was laboratory test, which fees accounted for 18.01%. The median LOS in case group was 12 days and the control was 10 days. Hospitalization days of infection group was 2 days longer than patients in control group with a significant difference (Z=-5.77, P<0.01).6. Total cost of multi-site infection was the highest with 5 052yuan, then followed by skin and soft tissue infections with 4 211 yuan. The lower respiratory tract infection was the third with 3 735yuan and the prolonged hospital day was the largest for 3 days.ConclusionsType 2 diabetes patients are more likely to develop nosocomial infections. Gender, age, admission time, hospitalization days, nutritional status, fasting blood glucose, motor nerve conduction velocity and course of disease were independent risk factors of type 2 diabetes mellitus with nosocomial infection. Preventive measures should be taken according to the above risk factors to reduce the incidence of nosocomial infection. There was a significant hospitalization costs and LOS rising in infection group, which were varied by infection sites.