A Real-World Study on Medical Resource Consumption in Multidrug-Resistant Organism Infections Under the DRG Payment...

Diagnosis-Related Groups (DRG) has become the predominant approach in China, while infections with multidrug-resistant organisms (MDRO) increase patient length of stay (LOS) and costs. Quantifying the impact of MDRO infections on medical resource consumption, providing a basis for hospitals' precise prevention and cost management.

A retrospective analysis was conducted on discharge patient data from a Grade A tertiary general hospital in China, from January 2023 to December 2024. Resource consumption was compared between MDRO-infected (by different sources and types) and non-infected groups. There were 953 patients in the MDRO-infected group and 210,608 in the non-MDRO-infected group. Differences in median LOS and hospitalization costs were further analyzed through DRGs stratification.

The overall incidence of MDRO infections was 0.571‰. The MDRO-infected (by different sources and types) had higher Time Consumption Index (TCI) and Cost Consumption Index (CCI) than the non-infected group (P < 0.05). Both indices use a benchmark of 1, with values exceeding 1 indicating prolonged hospitalization and cost overruns, respectively. Carbapenem-resistant Gram-negative bacilli (CR-GNB) had higher resource consumption, while methicillin-resistant Staphylococcus aureus (MRSA) had relatively lower. In ten high-infection-rate DRG, nine groups of infected patients had longer median LOS and higher median hospitalization costs (P<0.05). The infection group had a higher proportion of non-medical discharge and mortality. Non-medical discharge refers to voluntary departure against clinical recommendations for continued inpatient care.

MDRO infections substantially increase medical resource consumption. Strengthening the control of high-incidence MDRO DRG is necessary to help hospitals adapt to the DRG payment model.