摘要
目的了解冠脉支架植入术患者住院费用构成以及影响因素,为控制患者医疗费用、支付改革、强化医用耗材管理提供参考。方法选取W医院2019年至2023年上半年16810例开展了冠脉支架植入术患者的住院费用数据,采用结构变动度分析法及灰色关联分析法分析患者各项费用的占比变化、与住院费用的关联度等,并采用统计学方法分析集采前后主要耗材品类用量变化。结果2019年至2023年上半年,耗材费对冠脉支架植入术患者住院费用的结构变动贡献率最高,为49.20%。耗材费与患者的住院费用关联度最高,为0.922。2023年上半年相较2019年,检查费上涨81.99%。集采后,冠脉支架人均使用数量增加至2.13个。冠脉支架集采后月均患者人数上涨66.53%。结论冠脉支架植入术患者住院费用在取消耗材加成、实行带量采购后下降明显,集采是就医人数激增的内在驱动力,建议医院从优化医疗服务价格、加强医用耗材管理、建立规范化临床路径、推进集中带量采购政策等方面进一步控制患者住院费用。
Objective To investigate the composition of hospitalization costs for patients undergoing coronary stent implantation surgery and the influencing factors,providing a reference for controlling medical expenses,reforming payment and strengthening the management of medical consumables.Methods The data on hospitalization costs for 16810 patients undergoing coronary stent implantation surgery from 2019 to the first half of 2023 in W hospital was selected.Structural variation degree analysis and grey relational analysis methods were used to analyze the proportion changes of various expenses for patients and their correlation with hospitalization costs.Statistical methods were also used to analyze the changes in the consumption of major consumables before and after centralized procurement.Results From 2019 to the first half of 2023,the structural variation contribution rate of consumables expenses to the hospitalization costs of patients undergoing coronary stent implantation surgery was the highest,which was 49.20%.Consumables expenses had the highest correlation with hospitalization costs for patients,at 0.922.In the first half of 2023 compared to 2019,examination fees increased by 81.99%.After centralized procurement,the per capita use of coronary stent increased to 2.13.The monthly average number of patients undergoing coronary stent implantation surgery increased by 66.53%.Conclusion The hospitalization cost of patients undergoing coronary stent implantation surgery decreased significantly after the cancellation of consumables addition and the implementation of centralized procurement policy.Centralized procurement is the internal driving force behind the surge in medical visits.It is suggested that hospitals further control the hospitalization cost of patients by optimizing the prices of medical services,strengthening the management of medical consumables,establishing standardized clinical pathways,and promoting centralized quantity-based procurement policie.
作者
颜芬芬
YAN Fenfen(Department of Medical Equipment,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430030,China)
出处
《中国医疗设备》
2024年第9期107-112,共6页
China Medical Devices
基金
国家卫生健康委医院管理研究所基金(2022MEB210)。
关键词
冠脉支架植入术
结构变动度
灰色关联分析
住院费用
coronary stent implantation
degree of structure variation
grey relational analysis
hospitalization costs
