人工晶体集中带量采购政策对老年性白内障手术患者次均住院费用影响分析  

Analysis of the Impact of Intraocular Lens Centralized Volume-Based Procurement Policy on the Average Hospitalization Cost of Age-Related Cataract Surgery Patients

作　　者：彭勇华 姚卫光 PENG Yonghua;YAO Weiguang(School of Health Management,Southern Medical University,Guangzhou,Guangdong,510515,China;不详)

机构地区：[1]南方医科大学卫生管理学院,广东广州510515

出　　处：《中国卫生质量管理》2023年第8期25-29,共5页Chinese Health Quality Management

基　　金：广东省高校哲学社会科学重点实验室——公共卫生政策研究与评价资助项目(编号:2015SWSYS0010);广州公共卫生服务体系建设研究基地项目(编号:2021-2023)。

摘　　要：目的分析人工晶体集中带量采购政策下老年性白内障手术患者次均住院费用变化情况,为优化费用结构及完善医用耗材集中带量采购政策提供参考。方法收集2020年5月1日-2022年4月30日广州市某三甲公立综合医院行白内障超声乳化摘除术+人工晶体植入术的老年性白内障手术患者的病案首页中的费用信息,采用新灰色关联分析法与结构变动度分析法,研究次均住院费用与各类费用之间的关联程度、各类费用的结构变动程度和方向以及对次均住院费用的影响。结果老年性白内障手术患者次均住院费用关联度排名前3位的费用类别依次是治疗类(1.00)、耗材类(0.89)、诊断类(0.75)。2020年5月-2021年4月和2021年5月-2022年4月次均住院费用结构变动度为26.91%,结构变动贡献率排名前3位的费用类别依次是耗材类(49.75%)、治疗类(39.35%)、诊断类(6.56%),三者累积贡献率达95.66%。耗材类费用占比下降明显。结论人工晶体集中带量采购政策对降低老年性白内障手术患者次均住院费用及耗材类费用占比具有促进作用,使费用结构趋于合理,但耗材类费用和诊断类费用仍是影响次均住院费用的主要非技术劳动性费用类别。建议通过完善集中带量采购政策及规范医务人员诊疗行为等持续优化费用结构。Objective To analyze the changes of the average hospitalization cost and the proportion of various expenses of age-related cataract surgery patients after the implementation of the centralized volume-based procurement policy of intraocular lens,provide reference for optimizing the cost structure and improving the policy of centralized volune-based procurement of medical consumables.Methods The cost information from the first page of medical records of age-related cataract surgery patients who underwent phacoemulsification and intraocular lens implantation from May 1,2020 to April 30,2022 in a tertiary public general hospital in Guangzhou was collected,and the new gray correlation analysis method and structural variation analysis method were adopted.The correlation degree between the average hospitalization cost and each type of expense,the structural change degree and direction of each type of expense,and the influence on the average hospitalization cost were studied.Results The top three related cost categories were treatment(1.00),consumables(0.89)and diagnosis(0.75).The change degree of the average hospitalization cost structure was 26.91%between the period from May 2020 to April 2021 and from May 2021 to April 2022.The top three cost categories with the contribution rate of structural change were consumables(49.75%),treatment(39.35%),and diagnosis(6.56%),and the cumulative contribution rate of the three was 95.66%.The proportion of consumables expenses decreased significantly.Conclusion The implementation of the policy of centralized volume-based procurement of intraocular lens plays a positive role in reducing the average hospitalization cost and the proportion of consumables cost,and the cost structure tends to be reasonable.However,consumables cost and diagnostic cost are still the main non-technical labor cost categories that affect the average hospitalization cost.It is recommended to improve the policy of centralized volume-based procurement and standardize medical behavior to continuously control hospi

关 键 词：新灰色关联 结构变动度 人工晶体 集中带量采购 老年性白内障 次均住院费用 

分 类 号：R197.323[医药卫生—卫生事业管理]