摘要
目的:达芬奇机器人手术打造了闭环耗材系统,运行成本高,厘清不同术种不收费耗材用量及费用差异对医院控制成本、优化医疗资源配置具有重要意义。方法:由HIS拉取2019年12月至2021年12月达芬奇机器人病例数据进行整理,选取科室代表性的术种,调取手术团队日常运营记录进行统计描述和分析。结果:共开展878例,泌尿外科例数最多;医保覆盖人群比例较大;不同术种不收费耗材消耗量不同,为15047.51~20662.13元,耗材费用占术种平均手术费比例为19.16%~37.67%。结论:随着医保覆盖和机器人在微创治疗等方面优势,手术机器人普及度将进一步提升;不同术种达芬奇机器人手术耗材消耗量不同,耗材消耗费用异常值可能与手术难度较大有关,但也有可能存在浪费的现象。建立不收费医用耗材的动态监控机制,充分发挥医院专家作用,以术种为基础建立术种耗材使用的种类和合理数量的临床路径,规范使用和管理以减少浪费;亦可寻求物美价廉的替代品或通过集采等方式降低耗材价格,控制消耗成本,以提高医院经营效率,优化医疗资源配置。
Objective:da Vinci robotic surgery creates a closed-loop consumables system with high operating costs,and clarifying the amount and cost differences of non-chargeable consumables for different procedures is important for hospitals to control costs and optimize medical resource allocation.Methods:The data of da Vinci robot cases from December 2019 to December 2021 were pulled from the hospital information system(HIS)for collation,and representative types of procedures in each department were selected;the daily operation records of the surgical team were retrieved for statistical description and analysis.Results:A total of 878 cases were performed,with the largest number of urology cases;a larger proportion of the population was covered by medical insurance;the average consumption of no-charge consumables for different procedures ranged from$15,047.51 to$20,662.13,and the proportion of consumables costs to the average surgical fees for the procedures ranged from 19.16%to 37.67%.Conclusion:With the medical insurance coverage and robot in minimally invasive treatment and other aspects of the advantageous surgical robot popularity will further increase;the consumption of consumables for da Vinci robot surgery varies among different operation types,and the consumption cost outliers may be related to their greater surgical difficulty,but there may also be waste.It is recommended that the types and reasonable quantities of consumables for different surgical procedures should be managed by"quota and quantification"and"limit control"based on the type of surgery,so as to standardize the use and management to reduce waste;we can also seek cost-effective substitutes or reduce the cost of consumables by means of collective procurement.It is also possible to reduce the cost and price of consumables,control the cost of consumption,improve the efficiency of hospital operation,and optimize the allocation of medical resources.
作者
徐静芬
普鹰
侯文婷
张静宇
XU Jingfen;PU Ying;HOU Wenting;ZHANG Jingyu(Shanghai General Hospital,Shanghai 200080,China)
出处
《上海管理科学》
2023年第2期84-87,共4页
Shanghai Management Science
基金
中国民族卫生协会2023年度公立医院高质量发展科研项目(CNHA-2023-D-11)
上海市第一人民医院科研项目(YNGL-2022-45)。
关键词
成本管控视角
达芬奇机器人手术
不同术种
不收费耗材
cost control perspective
da Vinci robotic surgery
different types of surgery
no-charge consumables
