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.
Subject(s)
Cross Infection/economics , Hospital Costs , Hospitalization/economics , Adult , Aged , Aged, 80 and over , Case-Control Studies , China , Cross Infection/diagnosis , Female , Health Expenditures , Hospitalization/statistics & numerical data , Humans , Length of Stay , Male , Middle Aged , Propensity Score , Retrospective Studies , Tertiary Care CentersABSTRACT
A retrospective clinical study was conducted to evaluate the efficacies of various kinds of antibiotics on 804 patients with typhoid fever. Of 16 regimens studied, ofloxacin and enoxacin achieved 100 cure rates without relapse or carriage of Salmonella typhi within 3 months. Their good safety profiles and relatively lower costs were very cost-effective for treatment of typhoid fever, and they can be recommended as the first-line choices for routine management of this disease. In addition, our results suggested that ceftriaxone treatment of typhoid fever should be given at higher dose: not less than 3 g once daily, or over a longer period, to reduce the incidence of relapse.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Enoxacin/therapeutic use , Ofloxacin/therapeutic use , Typhoid Fever/drug therapy , Adult , Anti-Bacterial Agents/pharmacology , Enoxacin/pharmacology , Humans , Ofloxacin/pharmacology , Recurrence , Retrospective Studies , Salmonella typhi/drug effectsABSTRACT
An endoscopic survey was undertaken in Jiaoxian, People's Republic of China, a population at low risk for oesophageal cancer, to determine the prevalence of precancerous lesions of the oesophagus, and this rate was compared with the prevalence observed previously in high-risk populations in Iran and Linxian, China. The study involved 252 subjects whose exposure to suspected risk factors was determined by a questionnaire and all of whom underwent physical examination and oesophagoscopy, including cytology and biopsy. Chronic oesophagitis, with endoscopic and histologic characteristics similar to those observed in the high-risk populations of Iran and Linxian, was found in 28% of the study subjects compared to 80% in Iran and 65% in Linxian. Oesophagitis accompanied by atrophy of the epithelium was found in 0.4% compared to 10.5% in Iran and 10.8% in Linxian. No case of dysplasia was diagnosed in Jiaoxian while this condition was diagnosed in 4% of the subjects examined in Iran and in 8% of those in Linxian. The findings suggest that these lesions are in fact precancerous. Vitamin analysis showed that riboflavin deficiency was widespread in Jiaoxian, as in Iran and Linxian, but was more severe in Linxian than in Jiaoxian. No significant difference was found in the mean levels of retinol, beta-carotene and zinc between the two populations.
Subject(s)
Esophageal Neoplasms/epidemiology , Precancerous Conditions/epidemiology , Adolescent , Adult , China , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/pathology , Female , Humans , Male , Middle Aged , Precancerous Conditions/diagnosis , Precancerous Conditions/pathology , Risk , Surveys and QuestionnairesABSTRACT
To determine the prevalence of precursor lesions of oesophageal cancer in Linxian, People's Republic of China, which has an extremely high incidence of oesophageal cancer, 527 subjects were interviewed by a questionnaire about exposure to suspected risk factors. They also underwent oesophagoscopy, cytology, and biopsy. 84% had a chronic oesophagitis which had similar endoscopic and histological characteristics to that reported in Iran. The oesophagitis was accompanied by atrophy of the epithelium in 10% of these subjects and by dysplasia in 8%. Re-examination of 20 selected subjects 1 year later showed progression of the oesophagitis to atrophy and dysplasia in 4 individuals and to cancer in 4 others. The surveys in Iran and China suggest that the natural history of oesophageal cancer starts with an oesophagitis which, in a few individuals, progresses to atrophy and dysplasia of the epithelium and finally to cancer. Thermal injury resulting from the drinking of very hot beverages, physical injury caused by ingesting very coarse food, and deficiencies of riboflavine, vitamin A, and zinc are proposed as risk factors for these precursor lesions.
