Study of the direct medical economic burden of patients with healthcare- associated infection based on DRGs matching

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All patients enrolled in the Diagnosis Related Groups (DRGs) comprehensive evaluation and management system from January 1 to December 31, 2023, were categorized into healthcare-associated infection (HAI) and non-HAI groups. A 1:1 case matching was performed based on DRG classification, sex, and age (± 5 years). Differences in direct medical costs and length of stay (LOS) between the two groups were compared, followed by a subgroup analysis of infection-related economic burden across diagnostic categories. 726 pairs of HAI cases and non-HAI cases were successfully matched. The direct cost of the HAI group was CNY 16,251.63 higher than the non-HAI group (1.91 times higher, P < 0.001). The length of hospital stay in the HAI group was 10 days longer (1.71 times higher, P < 0.001), with significant cost increases in treatment fees and Western medicine ( P < 0.001). Among all Major Diagnostic Categories (MDCs), the infection and parasitic diseases group incurred the largest economic burden. For HAI patients with sepsis or severe sepsis requiring ≥ 96 hours of mechanical ventilation, the total cost was CNY 80,162.31 higher than non-HAI patients ( P = 0.003), and hospitalization duration increased by 17.5 days ( P = 0.003). In conclusion, implementing scientifically classified DRGs in HAI management provides a strategic framework for advancing precision-oriented healthcare administration. Diagnosis related groups Healthcare associated infection Direct medical economic burden Introduction To enable more scientific allocation of medical resources and standardization of healthcare practices, the National Healthcare Security Administration of China has drawn on international experience in recent years to deepen the reform of medical insurance payment methods[ 1 ]. In 2021, the General Office of the State Council of China issued the “14th Five-Year” National Medical Security Plan, emphasizing the continuous advancement of medical insurance payment reforms. It proposed the nationwide implementation of a diversified composite payment system, primarily based on diagnosis-related groups (DRGs) payment, to guide rational clinical practices and enhance the efficiency of healthcare fund utilization [ 2 ]. In the same year, the National Healthcare Security Administration of China released the Three-Year Action Plan for DRG/Diagnosis-Intervention Pocket (DIP) Payment Reform, highlighting a shift from the traditional “fee-for-service” model to a “diagnosis-related group payment” model as the cornerstone of medical insurance reform[ 1 ]. DRGs serve as a critical tool for reforming medical insurance payments and guiding the rational allocation of healthcare resources. According to the Technical Specifications for Chinese Healthcare Security Diagnosis-Related Group (CHS-DRG) Classification and Payment, DRG is a case-mix classification system. Cases are first categorized into Major Diagnostic Categories (MDCs) based on distinct disease types. Within the same MDC, cases are further differentiated into core DRG groups according to treatment methods. Finally, individual patient characteristics, such as age, complications, comorbidities, and birth weight, refine the grouping to establish specific DRG sets[ 3 ]. DRGs are instrumental in evaluating healthcare quality, efficiency, and medical insurance payments. Under this new payment model, medical institutions bear the additional economic burden caused by healthcare-associated infections (HAIs), as the fixed DRG-based payment does not account for excess costs from HAIs. HAIs are among the most common adverse events in healthcare delivery, imposing a significant burden on health systems[ 4 ]. The DRG payment reform will inevitably drive hospitals to adopt more refined management practices. Understanding the disease spectrum distribution, high-impact conditions, resource consumption patterns, and time utilization within medical institutions, as well as quantifying the economic losses attributable to HAIs, is essential for informing hospital resource allocation and infection prevention strategies. 1 Methods 1.1 Study population and study design This study retrospectively analyzed all discharged cases (January 1 to December 31, 2023) from a tertiary hospital in Chengdu enrolled in the hospital DRG Comprehensive Evaluation and Management System. Based on the Healthcare-Associated Infection Diagnostic Criteria, subjects were stratified into HAI (785 cases) and non-HAI (84,861 cases) groups. Data on MDCs and DRG classifications were extracted from the DRG system. At the same time, infection timing/diagnosis details were retrieved from the infection surveillance system, and direct medical economic burden metrics (hospitalization duration, total costs, treatment expenses) were sourced from the hospital management information system. HAI patients spanned 196 DRG groups; a 1:1 case matching (gender, age ± 5 years, DRG group) achieved 726 matched pairs (92.48% success rate), reducing post-match HAI coverage to 172 DRG groups. 1.2 Outcome measures The direct medical economic burden refers to the economic resources consumed in purchasing healthcare services, encompassing outpatient fees, hospitalization fees, medication costs, and other disease prevention/treatment expenses. Differences in direct economic burden and hospitalization duration between matched HAI and non-HAI cases under the CHS-DRG payment framework were analyzed. Subgroup analyses were further conducted for MDC categories and DRG groups with high HAI incidence within the hospital. 1.3 Statistical analysis SPSS 25.0 was used for data analysis. Categorical data were presented as frequencies, with intergroup comparisons using the χ ² test or Fisher’s exact probability method. Median (M) and interquartile range (IQR) were reported for skewed continuous data. Normally distributed data were compared using the t-test, while non-normally distributed data were analyzed with the Mann-Whitney U test. A significance level of P < 0.05 was applied. 2 Results 2.1 Patient characteristics From January 1 to December 31, 2023, 85,646 hospitalized patients were enrolled in the DRG system, with a cumulative hospitalization duration of 639,932 days. Among them, 785 cases were classified into the HAI group and 84,861 into the non-HAI group. The HAI incidence rate was 0.92%, and the HAI rate per 1,000 patient days was 1.23‰. Before case matching, significant differences were observed in gender and age distribution between the two groups ( P < 0.001, see Table 1 ). After matching, 726 pairs of HAI and non-HAI cases were formed, covering 172 DRG groups across 23 MDCs, and no significant differences were found in gender, age, or DRG group distribution (all P > 0.05, see Table 1 ). Table 1 Sex and age distribution of HAI and non-HAI patients before and after matching Characteristics Before matching After matching HAI non-HAI Z P HAI non-HAI Z P Gender Male 434 41,585 14.496 0.001 404 404 0 1 Female 351 43,276 321 321 Age [M, IQR] 68(76) 56(69) -14.833 < 0.001 68(23) 68(21) -0.38 0.71 2.2 Direct Medical Economic Burden of HAIs The median hospitalization duration for HAI patients was 24.00 days, 1.71 times longer than that of non-HAI patients. The median total hospitalization cost for HAI patients was CNY 34,056.08, 1.91 times higher than that of non-HAI patients. Treatment fees (CNY 2,992.24) and Western medicine expenses (CNY 2,930.46) were the largest cost increases. Except for traditional Chinese medicine costs, all other expense categories—bed fees, nursing fees, Western medicine, laboratory tests, surgery, treatment, and examination fees—were significantly higher in the HAI group compared to the non-HAI group (all P < 0.001, see Table 2 ). Table 2 Direct cost and hospital stay between HAI group and non-HAI group (CNY) Item HAI(n = 726) non-HAI(n = 726) Median Difference Statistic M IQR M IQR d Z P Length of Stay 24.00 24.00 14.00 15.00 10.00 -13.826 <0.001 Total Cost 34,056.08 49,663.60 17,804.45 28,177.43 16,251.63 -10.596 <0.001 Ward Charge 1,341.00 1,524.50 729.00 845.50 612.00 -14.197 <0.001 Treatment Fee 6,276.56 1,1631.63 3,284.32 5,929.55 2,992.24 -10.258 <0.001 Diagnostic Imaging Fee 2,079.50 2,862.25 1,425.00 1,868.00 654.00 -6.826 <0.001 Nursing Care Fee 830.00 1,317.00 442.00 595.50 388.00 -12.145 <0.001 Consultation Fee 428.00 432.00 258.00 256.00 170.00 -14.044 <0.001 Laboratory Test Fee 3,688.00 6,491.25 2,105.00 3,650.50 1,583.00 -11.895 <0.001 Western Medication Cost 6,797.58 11,142.96 3,867.12 7,456.31 2,930.46 -8.387 <0.001 Medical Supplies Cost 1,084.60 5,063.29 517.11 2,868.55 567.49 -6.913 <0.001 Chinese Patent Medicine Cost 680.04 1,581.08 473.60 1,138.28 206.44 -0.345 0.73 2.3 HAI Burden in MDC Subgroups Matched HAI cases covered 172 DRG groups across 23 MDCs. As Table 3 shows subgroup analysis focused on MDC groups with ≥ 20 HAI cases. The largest HAI subgroup was “Myeloproliferative Diseases and Dysfunction, Poorly Differentiated Neoplasms” (138 cases, 19.01% of total HAI cases), with an HAI incidence of 1.98%. In this subgroup, total hospitalization costs for HAI patients were CNY 14,652.75 higher ( P < 0.001), and hospitalization duration was 11.50 days longer ( P < 0.001) compared to non-HAI cases. The most significant differences in total costs (CNY 37,543.20, P < 0.001) and hospitalization duration (22.00 days, P < 0.001) were observed in the “Infectious and Parasitic Diseases (Systemic or Unspecified)” MDC. Except for “Circulatory System Diseases and Dysfunctions,” all other MDCs showed statistically significant differences in total costs and hospitalization duration between HAI and non-HAI groups ( P < 0.05). Table 3 Direct cost and hospital stay between HAI group and non-HAI group in different MDC group Major Diagnostic Categories Number of HAI Cases Total Medical Cost (CNY) Median Length of Stay (days) HAI non-HAI Difference Z P HAI non-HAI Difference Z/t P Myeloproliferative Diseases and Disorders and Poorly Differentiated Neoplasms 138 30,806.19 16,154.44 14,651.75 -4.725 < 0.001 26.00 14.50 11.50 -6.313 < 0.001 Diseases and Disorders of the Nervous System 135 49,989.93 21,158.03 28,831.90 -4.658 < 0.001 31.00 16.00 15.00 -5.870 < 0.001 Diseases and Disorders of the Respiratory System 96 30,274.77 16,908.73 13,366.04 -4.483 < 0.001 20.00 16.50 3.50 -3.467 < 0.001 Diseases and Disorders of the Digestive System 68 31,932.69 16,524.70 15,407.99 -3.599 < 0.001 23.00 12.50 10.50 -5.092 < 0.001 Diseases and Disorders of the Musculoskeletal System 46 26,920.48 18,392.64 8,527.84 -1.999 0.046 21.00 12.00 9.00 -4.025 < 0.001 Infectious and Parasitic Diseases (Systemic or Unspecified Sites) 40 69,914.79 32,371.59 37,543.20 -3.368 < 0.001 34.00 12.00 22.00 -5.224 < 0.001 Diseases and Disorders of the Kidney and Urinary System 34 30,452.64 17,741.42 12,711.23 -2.330 0.020 29.26 a 18.06 11.20 -3.079 0.003 Diseases and Disorders of the Circulatory System 30 21,262.62 18,522.92 2,739.71 -0.651 0.515 17.5 a 14.13 3.37 -1.412 0.163 Diseases and Disorders of the Liver, Biliary Tract, and Pancreas 29 12,796.39 12,796.39 15,775.76 -4.051 < 0.001 25.00 13.00 12.00 -3.893 < 0.001 Diseases and Disorders of the Blood, Blood-Forming Organs, and Immunity 24 10,238.30 10,238.30 7,394.29 -3.093 0.002 23.92 a 12.17 11.75 -3.406 0.002 Note: Superscript "a" usually indicates distributed data; Student's t-test was used for between-group comparisons. 2.4 Subgroup Analysis of High-Burden DRGs HAI cases were distributed across four DRG groups for the MDC “Infectious and Parasitic Diseases (Systemic or Unspecified),” which exhibited the highest cost and duration disparities ( Table 4 ) . Two DRGs-“Sepsis or Severe Sepsis with 96 Hours of Mechanical Ventilation” and “Sepsis or Severe Sepsis without 96 Hours of Mechanical Ventilation but with Major Complication & Comorbidity (MCC)”-accounted for 80% of HAI cases in this MDC. Table 4 Direct cost and hospital stay between HAI group and non-HAI group in different DRG group Item HAI(n = 726) non-HAI(n = 726) Difference Statistic M IQR M IQR Z P Sepsis/Severe Sepsis with Mechanical Ventilation ≥ 96 hours Length of Stay 32 33 14.5 15 17.5 -2.982 0.003 Total Cost 144,459.56 127,633.38 64,297.25 42,484.98 80,162.31 -2.977 0.003 Ward Charge 2,640.00 2,876.00 1,125.50 1,214.25 1,514.50 -3.166 0.002 Treatment Fee 36,178.24 24,887.63 15,842.68 9,693.86 20,335.56 -3.317 < 0.001 Diagnostic Imaging Fee 3,815.00 1,856.50 1,478.00 1,848.50 2,337.00 -2.977 0.003 Nursing Care Fee 5,260.66 10,565.83 3,013.76 2,803.60 2,246.90 -2.224 0.026 Consultation Fee 623.00 342.00 414.00 377.50 209.00 -2.488 0.013 Laboratory Test Fee 19,906.75 16,105.63 11,050.75 7,125.00 8,856.00 -2.864 0.004 Western Medication Cost 37,426.68 59,123.94 20,677.99 21,047.32 16,748.70 -1.847 0.065 Medical Supplies Cost 12,777.30 16,625.92 3,469.26 5,457.36 9,308.04 -2.676 0.007 Sepsis/Severe Sepsis without Mechanical Ventilation ≥ 96 hours (with MCC) Length of Stay 32 56 7 9 25 -3.604 < 0.001 Total Cost 52,321.08 99,250.71 11,843.52 16,238.47 40,477.55 -2.412 0.016 Ward Charge 1,999.00 3,379.50 411.5 332.50 1,587.50 -3.526 < 0.001 Treatment Fee 11,904.14 39,919.015 2,437.5 4,951.21 9,466.64 -2.525 0.012 Diagnostic Imaging Fee 3,169.00 2,746.80 790.00 740.00 2,379.00 -3.579 < 0.001 Nursing Care Fee 2,382.24 45,074.97 373.50 721.40 2,008.74 -2.827 0.005 Consultation Fee 838.00 922.50 173.00 226.00 665.00 -3.618 < 0.001 Laboratory Test Fee 9,886.50 9,637.50 3,499.50 3,366.63 6,387.00 -2.487 0.013 Western Medication Cost 11,465.58 1,980.88 3,796.34 6,981.37 7,669.245 -1.960 0.05 Medical Supplies Cost 1,469.29 2,480.63 447.36 932.27 1,021.93 -2.525 0.012 Sepsis/Severe Sepsis with Mechanical Ventilation (96 hours): HAI patients incurred total hospitalization costs of CNY 144,459.56, CNY 80,162.31 higher than non-HAI cases ( P = 0.003). Their hospitalization was 32.0 days, 17.5 days longer than non-HAI patients ( P = 0.003). Significant differences were observed in bed fees, treatment fees, examination fees, nursing fees, laboratory fees, and material costs (all P < 0.05), except for Western medicine expenses ( P = 0.065). Treatment fees for HAI patients were 2.28 times higher (CNY 20,335.56), and Western medicine costs 1.81 times higher (CNY 16,748.70) than non-HAI patients. Sepsis/Severe Sepsis without Mechanical Ventilation (96 hours) with MCC: The total cost difference between HAI and non-HAI cases was CNY 40,477.55, with the most significant disparity in treatment fees (CNY 9,466.64). All cost categories except Western medicine showed significant differences (all P < 0.05). 3 Discussion The reform of medical insurance payment methods and macro-regulation aims to shift regulatory focus from cost containment to dual control of healthcare costs and quality. Through DRG/DIP payment reforms, establishing efficient payment management and incentive mechanisms for medical institutions is the starting point and core objective of these reforms[ 5 ]. Under the DRG-based fixed payment model, insurance does not cover additional costs caused by HAIs, which incentivizes healthcare providers to improve infection control practices. However, this also raises higher demands for infection prevention infrastructure and specialized personnel. Identifying risks, reducing HAI incidence, alleviating disease burden, and enhancing operational efficiency remain critical priorities[ 6 ]. To better assess the disease burden of HAIs while balancing confounding factors between HAI and non-HAI cases, prior studies matched patients based on gender, age, department, or propensity scores[ 7 , 8 ]. However, HAI patients often present with more severe conditions and prolonged exposure risks, introducing bias. As a scientific grouping and evaluation tool, DRGs refine case classifications based on diagnoses, procedures, comorbidities, and demographic features. Patients within the same DRG group are assumed to have comparable hospitalization durations without confounding factors. Thus, our DRG-based 1:1 matching approach offers greater precision and scientific rigor than traditional methods limited by partial confounder control. This ensures enhanced comparability in diagnoses and demographics, yielding results closer to real-world impacts. HAIs impose a significant economic burden, directly increasing patient costs and conflicting with healthcare cost-control and quality improvement goals. A study in the EU/EEA estimated the cumulative burden of six HAIs at 501 disability-adjusted life years (DALYs) per 100,000 population (2011–2012), exceeding the total burden of 32 other infectious diseases (including influenza and tuberculosis) reported by the European Centre for Disease Prevention and Control (260 DALYs/100,000 population, 2009–2013)[ 9 ]. Studies from various countries have shown that each hospital-acquired infection (HAI) incurs an average cost of $ 1,000 to $ 123,000, imposing a substantial economic burden on healthcare systems[ 10 ]. For high-risk conditions, HAIs increase costs and prolong hospitalization [ 11 ]. The average hospitalization cost for patients infected with multidrug-resistant bacteria is higher than that of non-infected patients[ 12 ]. A study conducted at one of the largest tertiary hospitals in Sichuan, China, utilized multivariate analysis to identify confounders affecting hospitalization costs, followed by propensity score matching. The results revealed that hospitalization costs for HAI patients were EUR 2,198.19 higher (1.6-fold increase) compared to non-HAI patients[ 13 ], closely aligning with our findings of a CNY 16251 (1.71-fold) cost increase. In this study, HAI-induced cost increments varied across MDCs, ranging from CNY 2,700 to over CNY 37,000, with the most significant burdens observed in “Infectious and Parasitic Diseases” and “Nervous System Diseases and Dysfunctions.” Further DRG subgroup analysis revealed the most pronounced disparities in “Sepsis/Severe Sepsis with 96 Hours of Mechanical Ventilation,” where HAI patients faced a CNY 80,162.31 cost increase and 17.5-day hospitalization prolongation. Such high-burden DRG groups warrant prioritized surveillance and targeted infection control measures to mitigate economic and clinical impacts. Treatment costs constituted the primary driver of additional HAI-related expenses, reflecting increased medical interventions. Medication expenditures, particularly antibiotics, represented the second-largest burden. A meta-analysis by Lv et al. (2009–2019) found medication costs accounting for CNY 9,438 (38%) of the total CNY 24,881 HAI cost difference[ 14 ]. Similarly, in India, antibiotics comprised half of HAI-related medication expenses[ 15 ]. Furthermore, adjusted discounted costs for HAI patients rose from $ 3,703.82 in 2016 to $ 5235.90 in 2022 (a 1.41-fold increase), with annual cost growth rates (~ 7%) outpacing non-HAI cases[ 16 ]. Aging populations, invasive procedures, and complex surgeries will likely exacerbate infection risks and economic burdens. Underreporting of HAIs further suggests underestimated true burdens. Beyond direct costs, HAIs contribute to indirect losses (e.g., lost productivity) and systemic healthcare strain. While many HAIs are preventable, improving compliance with infection control protocols remains resource-intensive[ 17 ]. Thus, evidence-based prioritization of HAI burden assessments is essential to optimize resource allocation. 4 Conclusion The utilization of DRGs in the context of hospital-acquired infections offers a direction for precision management. Integrating DRGs into HAI management offers a strategic framework for precision-oriented governance and sustainable healthcare delivery. Declarations Ethics approval and consent to participate: The current study was conducted according to the guidelines in the Declaration of Helsinki, and all procedures involving research study participants were approved by the Ethics Committee of Chengdu First People’s Hospital, reference number 2025YNYJ040. Informed Consent Statement: All subjects gave their informed consent for inclusion before participating in the study. Competing interests: The authors declare that they have no competing interests. Authors’ contributions: Formal analysis, Yujing Zhang, Zhenhua Duan; Investigation, Yujing Zhang, Zhenhua Duan, Zhenhan Mo, Jianjun Xu, Han Zhang; Methodology, Yujing Zhang and Zhenhua Duan; Writing–original draft, Yujing Zhang; Writing-review & editing, Yujing Zhang. All authors have read and agreed to the published version of the manuscript. Acknowledgments: We thank the participants and the project staff for their enthusiasm and support. Funding: There are no funding sources to declare. Data Availability Statement: The dataset from the current analysis is not public, but is available from the corresponding author upon reasonable request. References China's National Healthcare Security Administration. (2024-04-10). How Does the Reform of Medical Insurance Payment Methods Affect Healthcare Access? https://www.nhsa.gov.cn/art/2024/4/10/art_14_12344.html The Central People's Government of the People's Republic of China. General Office of the State Council.(2021-09-29). Notice on Issuing the 14th Five-Year Plan National Healthcare Security Plan . https://www.gov.cn/zhengce/cont-ent/2021-09/29/content_5639967.htm China’s National Healthcare Security Administration. (2019-10-16). Technical Specifications for Diagnosis Related Grouping and Payment under China’s Healthcare Security System (CHS-DRG) . https://www.gov.cn/zhengce/zhengceku/2019-11/18/content_5562261.htm World Health Organization. (2021-05-28). Global report on infection prevention and control: executive summary . https://iris.who.int/handle/10665/354553 China’s National Healthcare Security Administration. (2021-11-19). Notice on Issuing the Three-Year Action Plan for DRG/DIP Payment Method Reform . https://www.gov.cn/zhengce/zhengceku/2021-11/28/content_5653858.htm Haque M, et al. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Manag Healthc Policy. 2020;13:1765–80. Yi X, et al. Efficacy of comprehensive unit-based safety program to prevent ventilator associated-pneumonia for mechanically ventilated patients in China: A propensity-matched analysis. Front Public Health. 2022;10:1029260. Xu X, et al. Association between perioperative allogeneic red blood cell transfusion and infection after clean-contaminated surgery: a retrospective cohort study. Br J Anaesth. 2021;127(3):405–14. Cassini A, et al. Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study. PLoS Med. 2016;13(10):e1002150. Forrester JD, Maggio PM, Tennakoon L. Cost of Health Care-Associated Infections in the United States. J Patient Saf. 2022;18(2):e477–9. Manoukian S, et al. Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK. J Hosp Infect. 2021;114:43–50. Nelson RE, et al. National Estimates of Healthcare Costs Associated With Multidrug-Resistant Bacterial Infections Among Hospitalized Patients in the United States. Clin Infect Dis. 2021;72(Suppl 1):S17–26. Lv Y, et al. Hospitalization costs due to healthcare-associated infections: An analysis of propensity score matching. J Infect Public Health. 2019;12(4):568–75. Liu X, et al. A systematic review and meta-analysis of disease burden of healthcare-associated infections in China: an economic burden perspective from general hospitals. J Hosp Infect. 2022;123:1–11. Tiwari P, Rohit M. Assessment of Costs Associated with Hospital-Acquired Infections in a Private Tertiary Care Hospital in India. Value Health Reg Issues. 2013;2(1):87–91. Lv Y, et al. Economic burden attributable to healthcare-associated infections at western China hospitals: 6 Year, prospective cohort study. J Infect. 2024;88(2):112–22. Zingg W, Holmes A, Dettenkofer M. Corrections. Hospital organization, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis. 2015;15(3):263. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6711523","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":467976462,"identity":"c86b2f83-a3a9-4d2d-bdd3-e4bffde1f995","order_by":0,"name":"Yujing Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYFACHiCu+C/Hz97Y+PAD8VrOMBtL9hxuNpYgWgtjG3PihhvpbQI8xGjQ7T978HNhG1vihpsP2xgkGOzkdBsIaDE7cC5ZesY5HuOZtxPbHhQwJBubHSCk5WCPgTRPmYRs3+3EdgMJhgOJ2whqOcxj/JuHzYCx4ebBNgkeorQc4zGT5mlLUJxwg5FYLWd4zKx5zhwABnIiMJANiPHL+TPGt3kqDgCj8vjDhx8q7OQIakEDBqQpHwWjYBSMglGAAwAAGxFEYV8fbjMAAAAASUVORK5CYII=","orcid":"","institution":"Chengdu First People’s Hospital","correspondingAuthor":true,"prefix":"","firstName":"Yujing","middleName":"","lastName":"Zhang","suffix":""},{"id":467976463,"identity":"cda9ad5d-7bdf-4671-ae8b-ff307eaa0388","order_by":1,"name":"Zhenhua Duan","email":"","orcid":"","institution":"Chengdu Center for Disease Control and Prevention(Chengdu Institute of Health Supervision)","correspondingAuthor":false,"prefix":"","firstName":"Zhenhua","middleName":"","lastName":"Duan","suffix":""},{"id":467976464,"identity":"2546e5d9-b2b7-4d7a-85de-ad1ffc1f5e62","order_by":2,"name":"Zhenhan Mo","email":"","orcid":"","institution":"Chengdu First People’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Zhenhan","middleName":"","lastName":"Mo","suffix":""},{"id":467976465,"identity":"a067d241-d0ed-4e20-8b19-afe79aaaca67","order_by":3,"name":"Jianjun Xu","email":"","orcid":"","institution":"Chengdu First People’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jianjun","middleName":"","lastName":"Xu","suffix":""},{"id":467976466,"identity":"cf87248f-bb4d-4f8f-9b39-6ba302ac822d","order_by":4,"name":"Han Zhang","email":"","orcid":"","institution":"Chengdu First People’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Han","middleName":"","lastName":"Zhang","suffix":""}],"badges":[],"createdAt":"2025-05-21 01:38:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6711523/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6711523/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84326412,"identity":"faa80b83-0a20-48d1-9cc9-330cdcbd7c39","added_by":"auto","created_at":"2025-06-10 15:10:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":983049,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6711523/v1/c36ed0d7-8bfd-4475-8967-2eca937acb27.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Study of the direct medical economic burden of patients with healthcare- associated infection based on DRGs matching","fulltext":[{"header":"Introduction","content":"\u003cp\u003eTo enable more scientific allocation of medical resources and standardization of healthcare practices, the National Healthcare Security Administration of China has drawn on international experience in recent years\u003c/p\u003e \u003cp\u003eto deepen the reform of medical insurance payment methods[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In 2021, the General Office of the State Council of China issued the \u0026ldquo;14th Five-Year\u0026rdquo; National Medical Security Plan, emphasizing the continuous advancement of medical insurance payment reforms. It proposed the nationwide implementation of a diversified composite payment system, primarily based on diagnosis-related groups (DRGs) payment, to guide rational clinical practices and enhance the efficiency of healthcare fund utilization [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In the same year, the National Healthcare Security Administration of China released the Three-Year Action Plan for DRG/Diagnosis-Intervention Pocket (DIP) Payment Reform, highlighting a shift from the traditional \u0026ldquo;fee-for-service\u0026rdquo; model to a \u0026ldquo;diagnosis-related group payment\u0026rdquo; model as the cornerstone of medical insurance reform[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDRGs serve as a critical tool for reforming medical insurance payments and guiding the rational allocation of healthcare resources. According to the Technical Specifications for Chinese Healthcare Security Diagnosis-Related Group (CHS-DRG) Classification and Payment, DRG is a case-mix classification system. Cases are first categorized into Major Diagnostic Categories (MDCs) based on distinct disease types. Within the same MDC, cases are further differentiated into core DRG groups according to treatment methods. Finally, individual patient characteristics, such as age, complications, comorbidities, and birth weight, refine the grouping to establish specific DRG sets[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. DRGs are instrumental in evaluating healthcare quality, efficiency, and medical insurance payments. Under this new payment model, medical institutions bear the additional economic burden caused by healthcare-associated infections (HAIs), as the fixed DRG-based payment does not account for excess costs from HAIs.\u003c/p\u003e \u003cp\u003eHAIs are among the most common adverse events in healthcare delivery, imposing a significant burden on health systems[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The DRG payment reform will inevitably drive hospitals to adopt more refined management practices. Understanding the disease spectrum distribution, high-impact conditions, resource consumption patterns, and time utilization within medical institutions, as well as quantifying the economic losses attributable to HAIs, is essential for informing hospital resource allocation and infection prevention strategies.\u003c/p\u003e"},{"header":"1 Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Study population and study design\u003c/h2\u003e \u003cp\u003eThis study retrospectively analyzed all discharged cases (January 1 to December 31, 2023) from a tertiary hospital in Chengdu enrolled in the hospital DRG Comprehensive Evaluation and Management System. Based on the Healthcare-Associated Infection Diagnostic Criteria, subjects were stratified into HAI (785 cases) and non-HAI (84,861 cases) groups. Data on MDCs and DRG classifications were extracted from the DRG system. At the same time, infection timing/diagnosis details were retrieved from the infection surveillance system, and direct medical economic burden metrics (hospitalization duration, total costs, treatment expenses) were sourced from the hospital management information system. HAI patients spanned 196 DRG groups; a 1:1 case matching (gender, age\u0026thinsp;\u0026plusmn;\u0026thinsp;5 years, DRG group) achieved 726 matched pairs (92.48% success rate), reducing post-match HAI coverage to 172 DRG groups.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e1.2 Outcome measures\u003c/h3\u003e\n\u003cp\u003eThe direct medical economic burden refers to the economic resources consumed in purchasing healthcare services, encompassing outpatient fees, hospitalization fees, medication costs, and other disease prevention/treatment expenses. Differences in direct economic burden and hospitalization duration between matched HAI and non-HAI cases under the CHS-DRG payment framework were analyzed. Subgroup analyses were further conducted for MDC categories and DRG groups with high HAI incidence within the hospital.\u003c/p\u003e\n\u003ch3\u003e1.3 Statistical analysis\u003c/h3\u003e\n\u003cp\u003eSPSS 25.0 was used for data analysis. Categorical data were presented as frequencies, with intergroup comparisons using the \u003cem\u003eχ\u003c/em\u003e\u0026sup2; test or Fisher\u0026rsquo;s exact probability method. Median (M) and interquartile range (IQR) were reported for skewed continuous data. Normally distributed data were compared using the t-test, while non-normally distributed data were analyzed with the Mann-Whitney U test. A significance level of \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was applied.\u003c/p\u003e"},{"header":"2 Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Patient characteristics\u003c/h2\u003e \u003cp\u003eFrom January 1 to December 31, 2023, 85,646 hospitalized patients were enrolled in the DRG system, with a cumulative hospitalization duration of 639,932 days. Among them, 785 cases were classified into the HAI group and 84,861 into the non-HAI group. The HAI incidence rate was 0.92%, and the HAI rate per 1,000 patient days was 1.23\u0026permil;. Before case matching, significant differences were observed in gender and age distribution between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). After matching, 726 pairs of HAI and non-HAI cases were formed, covering 172 DRG groups across 23 MDCs, and no significant differences were found in gender, age, or DRG group distribution (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05, see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSex and age distribution of HAI and non-HAI patients before and after matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eBefore matching\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e \u003cp\u003eAfter matching\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003enon-HAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003enon-HAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e434\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41,585\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43,276\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e321\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e321\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge [M, IQR]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68(76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56(69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-14.833\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e68(23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e68(21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Direct Medical Economic Burden of HAIs\u003c/h2\u003e \u003cp\u003eThe median hospitalization duration for HAI patients was 24.00 days, 1.71 times longer than that of non-HAI patients. The median total hospitalization cost for HAI patients was CNY 34,056.08, 1.91 times higher than that of non-HAI patients. Treatment fees (CNY 2,992.24) and Western medicine expenses (CNY 2,930.46) were the largest cost increases. Except for traditional Chinese medicine costs, all other expense categories\u0026mdash;bed fees, nursing fees, Western medicine, laboratory tests, surgery, treatment, and examination fees\u0026mdash;were significantly higher in the HAI group compared to the non-HAI group (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDirect cost and hospital stay between HAI group and non-HAI group (CNY)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHAI(n\u0026thinsp;=\u0026thinsp;726)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003enon-HAI(n\u0026thinsp;=\u0026thinsp;726)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian Difference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003eStatistic\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eIQR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eIQR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ed\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of Stay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e10.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-13.826\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34,056.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49,663.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17,804.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e28,177.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e16,251.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-10.596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWard Charge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,341.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,524.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e729.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e845.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e612.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-14.197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTreatment Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6,276.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,1631.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3,284.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5,929.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2,992.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-10.258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnostic Imaging Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2,079.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2,862.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1,425.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1,868.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e654.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-6.826\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing Care Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e830.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,317.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e442.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e595.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e388.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-12.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsultation Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e428.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e432.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e258.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e256.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e170.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-14.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaboratory Test Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3,688.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6,491.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2,105.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3,650.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1,583.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-11.895\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWestern Medication Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6,797.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11,142.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3,867.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7,456.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2,930.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-8.387\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical Supplies Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,084.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5,063.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e517.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2,868.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e567.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-6.913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChinese Patent Medicine Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e680.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,581.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e473.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1,138.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e206.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e2.3 HAI Burden in MDC Subgroups\u003c/h3\u003e\n\u003cp\u003eMatched HAI cases covered 172 DRG groups across 23 MDCs. As Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows subgroup analysis focused on MDC groups with \u0026ge;\u0026thinsp;20 HAI cases. The largest HAI subgroup was \u0026ldquo;Myeloproliferative Diseases and Dysfunction, Poorly Differentiated Neoplasms\u0026rdquo; (138 cases, 19.01% of total HAI cases), with an HAI incidence of 1.98%. In this subgroup, total hospitalization costs for HAI patients were CNY 14,652.75 higher (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and hospitalization duration was 11.50 days longer (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) compared to non-HAI cases. The most significant differences in total costs (CNY 37,543.20, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and hospitalization duration (22.00 days, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were observed in the \u0026ldquo;Infectious and Parasitic Diseases (Systemic or Unspecified)\u0026rdquo; MDC. Except for \u0026ldquo;Circulatory System Diseases and Dysfunctions,\u0026rdquo; all other MDCs showed statistically significant differences in total costs and hospitalization duration between HAI and non-HAI groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDirect cost and hospital stay between HAI group and non-HAI group in different MDC group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMajor Diagnostic Categories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of\u003c/p\u003e \u003cp\u003eHAI Cases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c7\" namest=\"c3\"\u003e \u003cp\u003eTotal Medical Cost (CNY)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c13\" namest=\"c9\"\u003e \u003cp\u003eMedian Length of Stay (days)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003enon-HAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDifference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003enon-HAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eDifference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cem\u003eZ/t\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMyeloproliferative Diseases and Disorders and Poorly Differentiated Neoplasms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30,806.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,154.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14,651.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-4.725\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e26.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e14.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e11.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-6.313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Nervous System\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49,989.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21,158.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28,831.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-4.658\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e31.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e16.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-5.870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Respiratory System\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30,274.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,908.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13,366.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-4.483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e16.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e3.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-3.467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Digestive System\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31,932.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,524.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15,407.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-3.599\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e12.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e10.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-5.092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Musculoskeletal System\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26,920.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18,392.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8,527.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e12.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e9.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-4.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfectious and Parasitic Diseases (Systemic or Unspecified Sites)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69,914.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32,371.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37,543.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-3.368\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e34.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e12.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-5.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Kidney and Urinary System\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30,452.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17,741.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12,711.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-2.330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e29.26\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e18.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e11.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-3.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Circulatory System\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21,262.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18,522.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2,739.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.651\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e17.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e14.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e3.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-1.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.163\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Liver, Biliary Tract, and Pancreas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12,796.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12,796.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15,775.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-4.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e25.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e13.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e12.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-3.893\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiseases and Disorders of the Blood, Blood-Forming Organs, and Immunity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10,238.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10,238.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7,394.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-3.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e23.92\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e12.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e11.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-3.406\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eNote: Superscript \"a\" usually indicates distributed data; Student's t-test was used for between-group comparisons.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003e2.4 Subgroup Analysis of High-Burden DRGs\u003c/h3\u003e\n\u003cp\u003eHAI cases were distributed across four DRG groups for the MDC \u0026ldquo;Infectious and Parasitic Diseases (Systemic or Unspecified),\u0026rdquo; which exhibited the highest cost and duration disparities \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Two DRGs-\u0026ldquo;Sepsis or Severe Sepsis with 96 Hours of Mechanical Ventilation\u0026rdquo; and \u0026ldquo;Sepsis or Severe Sepsis without 96 Hours of Mechanical Ventilation but with Major Complication \u0026amp; Comorbidity (MCC)\u0026rdquo;-accounted for 80% of HAI cases in this MDC.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDirect cost and hospital stay between HAI group and non-HAI group in different DRG group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eHAI(n\u0026thinsp;=\u0026thinsp;726)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003enon-HAI(n\u0026thinsp;=\u0026thinsp;726)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDifference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003eStatistic\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eIQR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eIQR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eSepsis/Severe Sepsis with Mechanical Ventilation\u0026thinsp;\u0026ge;\u0026thinsp;96 hours\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLength of Stay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144,459.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e127,633.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e64,297.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42,484.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e80,162.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWard Charge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2,640.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,876.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,125.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1,214.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,514.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-3.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTreatment Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36,178.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24,887.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15,842.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9,693.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20,335.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-3.317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiagnostic Imaging Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3,815.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,856.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,478.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1,848.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,337.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNursing Care Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5,260.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10,565.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3,013.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2,803.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,246.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConsultation Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e623.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e342.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e414.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e377.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e209.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.488\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLaboratory Test Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19,906.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16,105.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11,050.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7,125.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8,856.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.864\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWestern Medication Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37,426.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59,123.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20,677.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21,047.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e16,748.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-1.847\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical Supplies Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12,777.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16,625.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3,469.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5,457.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9,308.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.676\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSepsis/Severe Sepsis without Mechanical Ventilation\u0026thinsp;\u0026ge;\u0026thinsp;96 hours (with MCC)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLength of Stay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-3.604\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52,321.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99,250.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11,843.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16,238.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e40,477.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWard Charge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,999.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3,379.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e411.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e332.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,587.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-3.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTreatment Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11,904.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39,919.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2,437.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4,951.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9,466.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiagnostic Imaging Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3,169.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,746.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e790.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e740.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,379.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-3.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNursing Care Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2,382.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45,074.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e373.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e721.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,008.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConsultation Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e838.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e922.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e173.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e226.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e665.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-3.618\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLaboratory Test Fee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9,886.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9,637.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3,499.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3,366.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6,387.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.487\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWestern Medication Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11,465.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,980.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3,796.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6,981.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7,669.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-1.960\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical Supplies Cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,469.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,480.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e447.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e932.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,021.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-2.525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSepsis/Severe Sepsis with Mechanical Ventilation (96 hours):\u003c/p\u003e \u003cp\u003eHAI patients incurred total hospitalization costs of CNY 144,459.56, CNY 80,162.31 higher than non-HAI cases (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003). Their hospitalization was 32.0 days, 17.5 days longer than non-HAI patients (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003). Significant differences were observed in bed fees, treatment fees, examination fees, nursing fees, laboratory fees, and material costs (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), except for Western medicine expenses (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.065). Treatment fees for HAI patients were 2.28 times higher (CNY 20,335.56), and Western medicine costs 1.81 times higher (CNY 16,748.70) than non-HAI patients.\u003c/p\u003e \u003cp\u003eSepsis/Severe Sepsis without Mechanical Ventilation (96 hours) with MCC:\u003c/p\u003e \u003cp\u003eThe total cost difference between HAI and non-HAI cases was CNY 40,477.55, with the most significant disparity in treatment fees (CNY 9,466.64). All cost categories except Western medicine showed significant differences (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"3 Discussion","content":" \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003cp\u003eThe reform of medical insurance payment methods and macro-regulation aims to shift regulatory focus from cost containment to dual control of healthcare costs and quality. Through DRG/DIP payment reforms, establishing efficient payment management and incentive mechanisms for medical institutions is the starting point and core objective of these reforms[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Under the DRG-based fixed payment model, insurance does not cover additional costs caused by HAIs, which incentivizes healthcare providers to improve infection control practices. However, this also raises higher demands for infection prevention infrastructure and specialized personnel. Identifying risks, reducing HAI incidence, alleviating disease burden, and enhancing operational efficiency remain critical priorities[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo better assess the disease burden of HAIs while balancing confounding factors between HAI and non-HAI cases, prior studies matched patients based on gender, age, department, or propensity scores[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, HAI patients often present with more severe conditions and prolonged exposure risks, introducing bias. As a scientific grouping and evaluation tool, DRGs refine case classifications based on diagnoses, procedures, comorbidities, and demographic features. Patients within the same DRG group are assumed to have comparable hospitalization durations without confounding factors. Thus, our DRG-based 1:1 matching approach offers greater precision and scientific rigor than traditional methods limited by partial confounder control. This ensures enhanced comparability in diagnoses and demographics, yielding results closer to real-world impacts.\u003c/p\u003e \u003cp\u003eHAIs impose a significant economic burden, directly increasing patient costs and conflicting with healthcare cost-control and quality improvement goals. A study in the EU/EEA estimated the cumulative burden of six HAIs at 501 disability-adjusted life years (DALYs) per 100,000 population (2011\u0026ndash;2012), exceeding the total burden of 32 other infectious diseases (including influenza and tuberculosis) reported by the European Centre for Disease Prevention and Control (260 DALYs/100,000 population, 2009\u0026ndash;2013)[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Studies from various countries have shown that each hospital-acquired infection (HAI) incurs an average cost of \u003cspan\u003e$\u003c/span\u003e1,000 to \u003cspan\u003e$\u003c/span\u003e123,000, imposing a substantial economic burden on healthcare systems[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. For high-risk conditions, HAIs increase costs and prolong hospitalization [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The average hospitalization cost for patients infected with multidrug-resistant bacteria is higher than that of non-infected patients[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. A study conducted at one of the largest tertiary hospitals in Sichuan, China, utilized multivariate analysis to identify confounders affecting hospitalization costs, followed by propensity score matching. The results revealed that hospitalization costs for HAI patients were EUR 2,198.19 higher (1.6-fold increase) compared to non-HAI patients[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], closely aligning with our findings of a CNY 16251 (1.71-fold) cost increase.\u003c/p\u003e \u003cp\u003eIn this study, HAI-induced cost increments varied across MDCs, ranging from CNY 2,700 to over CNY 37,000, with the most significant burdens observed in \u0026ldquo;Infectious and Parasitic Diseases\u0026rdquo; and \u0026ldquo;Nervous System Diseases and Dysfunctions.\u0026rdquo; Further DRG subgroup analysis revealed the most pronounced disparities in \u0026ldquo;Sepsis/Severe Sepsis with 96 Hours of Mechanical Ventilation,\u0026rdquo; where HAI patients faced a CNY 80,162.31 cost increase and 17.5-day hospitalization prolongation. Such high-burden DRG groups warrant prioritized surveillance and targeted infection control measures to mitigate economic and clinical impacts.\u003c/p\u003e \u003cp\u003eTreatment costs constituted the primary driver of additional HAI-related expenses, reflecting increased medical interventions. Medication expenditures, particularly antibiotics, represented the second-largest burden. A meta-analysis by Lv et al. (2009\u0026ndash;2019) found medication costs accounting for CNY 9,438 (38%) of the total CNY 24,881 HAI cost difference[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Similarly, in India, antibiotics comprised half of HAI-related medication expenses[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Furthermore, adjusted discounted costs for HAI patients rose from \u003cspan\u003e$\u003c/span\u003e3,703.82 in 2016 to \u003cspan\u003e$\u003c/span\u003e5235.90 in 2022 (a 1.41-fold increase), with annual cost growth rates (~\u0026thinsp;7%) outpacing non-HAI cases[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Aging populations, invasive procedures, and complex surgeries will likely exacerbate infection risks and economic burdens. Underreporting of HAIs further suggests underestimated true burdens.\u003c/p\u003e \u003cp\u003eBeyond direct costs, HAIs contribute to indirect losses (e.g., lost productivity) and systemic healthcare strain. While many HAIs are preventable, improving compliance with infection control protocols remains resource-intensive[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Thus, evidence-based prioritization of HAI burden assessments is essential to optimize resource allocation.\u003c/p\u003e \u003c/div\u003e "},{"header":"4 Conclusion","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003cp\u003eThe utilization of DRGs in the context of hospital-acquired infections offers a direction for precision management. Integrating DRGs into HAI management offers a strategic framework for precision-oriented governance and sustainable healthcare delivery.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u0026nbsp;\u003c/strong\u003eThe current study was conducted according to the guidelines in the Declaration of Helsinki, and all procedures involving research study participants were approved by the Ethics Committee of Chengdu First People\u0026rsquo;s Hospital, reference number 2025YNYJ040.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u0026nbsp;\u003c/strong\u003eAll subjects gave their informed consent for inclusion before participating in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u0026nbsp;\u003c/strong\u003eFormal analysis, Yujing Zhang, Zhenhua Duan; Investigation, Yujing Zhang, Zhenhua Duan, Zhenhan Mo, Jianjun Xu, Han Zhang; Methodology, Yujing Zhang and Zhenhua Duan; Writing\u0026ndash;original draft, Yujing Zhang; Writing-review \u0026amp; editing, Yujing Zhang. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e We thank the participants and the project staff for their enthusiasm and support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e There are no funding sources to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e The dataset from the current analysis is not public, but is available from the corresponding author upon reasonable request.\u003cstrong\u003e\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eChina's National Healthcare Security Administration. 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General Office of the State Council.(2021-09-29). \u003cem\u003eNotice on Issuing the 14th Five-Year Plan National Healthcare Security Plan\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.gov.cn/zhengce/cont-ent/2021-09/29/content_5639967.htm\u003c/span\u003e\u003cspan address=\"https://www.gov.cn/zhengce/cont-ent/2021-09/29/content_5639967.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChina\u0026rsquo;s National Healthcare Security Administration. (2019-10-16). \u003cem\u003eTechnical Specifications for Diagnosis Related Grouping and Payment under China\u0026rsquo;s Healthcare Security System (CHS-DRG)\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.gov.cn/zhengce/zhengceku/2019-11/18/content_5562261.htm\u003c/span\u003e\u003cspan address=\"https://www.gov.cn/zhengce/zhengceku/2019-11/18/content_5562261.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. (2021-05-28). \u003cem\u003eGlobal report on infection prevention and control: executive summary\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://iris.who.int/handle/10665/354553\u003c/span\u003e\u003cspan address=\"https://iris.who.int/handle/10665/354553\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChina\u0026rsquo;s National Healthcare Security Administration. (2021-11-19). \u003cem\u003eNotice on Issuing the Three-Year Action Plan for DRG/DIP Payment Method Reform\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.gov.cn/zhengce/zhengceku/2021-11/28/content_5653858.htm\u003c/span\u003e\u003cspan address=\"https://www.gov.cn/zhengce/zhengceku/2021-11/28/content_5653858.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaque M, et al. Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Manag Healthc Policy. 2020;13:1765\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYi X, et al. Efficacy of comprehensive unit-based safety program to prevent ventilator associated-pneumonia for mechanically ventilated patients in China: A propensity-matched analysis. 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Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK. J Hosp Infect. 2021;114:43\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNelson RE, et al. National Estimates of Healthcare Costs Associated With Multidrug-Resistant Bacterial Infections Among Hospitalized Patients in the United States. Clin Infect Dis. 2021;72(Suppl 1):S17\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLv Y, et al. Hospitalization costs due to healthcare-associated infections: An analysis of propensity score matching. J Infect Public Health. 2019;12(4):568\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu X, et al. A systematic review and meta-analysis of disease burden of healthcare-associated infections in China: an economic burden perspective from general hospitals. J Hosp Infect. 2022;123:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTiwari P, Rohit M. Assessment of Costs Associated with Hospital-Acquired Infections in a Private Tertiary Care Hospital in India. Value Health Reg Issues. 2013;2(1):87\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLv Y, et al. Economic burden attributable to healthcare-associated infections at western China hospitals: 6 Year, prospective cohort study. J Infect. 2024;88(2):112\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZingg W, Holmes A, Dettenkofer M. Corrections. Hospital organization, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis. 2015;15(3):263.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Diagnosis related groups, Healthcare associated infection, Direct medical economic burden","lastPublishedDoi":"10.21203/rs.3.rs-6711523/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6711523/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eTo discuss the direct economic burden of healthcare-associated infection (HAI) in a hospital in Chengdu. All patients enrolled in the Diagnosis Related Groups (DRGs) comprehensive evaluation and management system from January 1 to December 31, 2023, were categorized into healthcare-associated infection (HAI) and non-HAI groups. A 1:1 case matching was performed based on DRG classification, sex, and age (\u0026plusmn;\u0026thinsp;5 years). Differences in direct medical costs and length of stay (LOS) between the two groups were compared, followed by a subgroup analysis of infection-related economic burden across diagnostic categories. 726 pairs of HAI cases and non-HAI cases were successfully matched. The direct cost of the HAI group was CNY 16,251.63 higher than the non-HAI group (1.91 times higher, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The length of hospital stay in the HAI group was 10 days longer (1.71 times higher, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with significant cost increases in treatment fees and Western medicine (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Among all Major Diagnostic Categories (MDCs), the infection and parasitic diseases group incurred the largest economic burden. For HAI patients with sepsis or severe sepsis requiring\u0026thinsp;\u0026ge;\u0026thinsp;96 hours of mechanical ventilation, the total cost was CNY 80,162.31 higher than non-HAI patients (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003), and hospitalization duration increased by 17.5 days (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003). In conclusion, implementing scientifically classified DRGs in HAI management provides a strategic framework for advancing precision-oriented healthcare administration.\u003c/p\u003e","manuscriptTitle":"Study of the direct medical economic burden of patients with healthcare- associated infection based on DRGs matching","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-10 14:54:02","doi":"10.21203/rs.3.rs-6711523/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-18T10:23:53+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"325617768769306421137378513368842809140","date":"2026-03-18T06:08:13+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-17T22:38:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"166192627483147935831691943215118766067","date":"2026-03-15T19:32:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"251513006141029371106471601745551855263","date":"2026-01-13T04:31:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60156066825278210852392415394788149532","date":"2025-11-14T14:28:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"1524866403148752703109068536799659971","date":"2025-11-07T13:29:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"171023159202784103544643943283635153535","date":"2025-08-28T08:20:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-28T19:21:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"322339786902616133932577027834137953808","date":"2025-06-07T16:50:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-05T10:42:13+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-28T10:01:52+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-27T09:48:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-27T09:26:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-05-27T09:24:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"528704e2-0621-4d9b-87fe-904f04e8c5eb","owner":[],"postedDate":"June 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T05:08:23+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-10 14:54:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6711523","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6711523","identity":"rs-6711523","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}