北京医耗联动综合改革对肺癌手术病例住院费用的影响  

The Impact of Beijing Medicine-Consumables Expenditures Linkage Comprehensive Reform on the Hospitalization Cost of Lung Cancer Patients Undergoing Surgery

作　　者：季新强[1] 王小艺 张耀光 Ji Xinqiang;Wang Xiaoyi;Zhang Yaoguang(Peking University Cancer Hospital,Beijing,100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所,北京100142 [2]国家卫生健康委统计信息中心,北京100144

出　　处：《中国医院管理》2022年第1期64-67,共4页Chinese Hospital Management

基　　金：国家重点研发计划(2017YFC0907401)。

摘　　要：目的评价北京市医耗联动综合改革对肺癌手术病例住院费用的影响。方法收集样本医院2018年1月—2019年12月所有出院肺癌手术病例病案首页数据,采用描述性分析和间断时间序列分析的方法,分析改革对肺癌手术病例住院费用和费用结构的影响。结果与改革前相比较,改革后研究医院肺癌手术病例例均总费用增幅为6.87%,例均化验费、药费分别有9.75%、7.42%的降幅,化验费占比较、药费占比均呈下降趋势(P<0.10);手术费增加了255.77%,手术费占比呈增加趋势(P<0.10);耗材费用增加了3.54%,病理费增加了10.18%,耗材费占比和病理费占比均有一定的降低。结论北京市医耗联动综合改革未对肺癌手术病例的收治情况产生影响。肺癌手术病例住院费用结构得到优化,但是仍须继续控制住院总费用,特别是控制耗材费用。Objective To evaluate the impact of Beijing medicine-consumables expenditures linkage comprehensive reform on the hospitalization cost of lung cancer surgery cases in Beijing. Methods Data from the first page of medical records of all discharged lung cancer surgery cases in the study hospital from January 2018 to December 2019 were collected. Descriptive analysis and Interrupted Time Series Analysis(ITSA) were used to analyze the impact of the reform on the inpatient hospitalization cost and structure of lung cancer surgery cases. Results Compared with before reform,the total hospitalization cost of lung cancer surgery cases in the research hospital increased by 6.87%,the average laboratory cost and drug cost decreased by 9.75% and 7.42%,respectively,and the proportion of laboratory cost and drug cost showed a decreasing trend(P<0.10). The operation cost increased by 255.77%,and the proportion of operation cost showed an increasing trend(P<0.10). The cost of consumables increased by 3.54%,and the cost of pathology increased by 10.18%. The proportion of the cost of consumables and the proportion of the cost of pathology decreased to some extent. Conclusion The Beijing medicine-consumables expenditures linkage comprehensive reform has no impact on the admission and treatment of lung cancer patients. The structure of hospitalization costs for lung cancer surgery cases has been optimized,but the total hospitalization costs of patients must continue to be controlled,especially the cost of consumables.

关 键 词：医耗联动综合改革 肺癌 手术病例 住院费用 间断时间序列分析 

分 类 号：R197.322[医药卫生—卫生事业管理]