冠脉支架集采政策前后经皮冠状动脉支架治疗绩效评价的中断时间序列分析  

Interrupted time series analysis of percutaneous coronary stent treatment performance evaluation before and after centralized procurement policy of coronary stents

作　　者：何文思 刘可心 黄华[1] 徐大文[1] 李诗洋 HE Wensi;LIU Kexin;HUANG Hua;XU Dawen;LI Shiyang(Panzhihua Central Hospital,Panzhihua 617067,China;Sichuan University,Chengdu 610065,China)

机构地区：[1]攀枝花市中心医院,四川攀枝花617067 [2]四川大学,四川成都610065

出　　处：《现代医院》2023年第11期1705-1708,共4页Modern Hospitals

基　　金：四川省医学会2020年四川省医学(青年创新)科研课题(S20020);攀枝花市科学技术局2020年度市级指导性科技计划项目(第二批)(2020ZD-S-5)。

摘　　要：目的 探讨冠脉支架集采政策对冠脉支架治疗绩效评价的影响。方法 通过采集某市三级甲等医院心血管内科2020年1月—2021年12月冠脉支架置入术的出院患者数据,利用ITSA模型从效率、费用等维度评价政策对冠脉支架置入术的影响。结果 冠脉支架集采政策对于冠脉支架置入术在次均费用、材料费用占比、医疗服务收入占比等指标存在显著影响,但对于例数和平均住院时间等指标影响不显著。结论 冠脉支架集采政策对于冠脉支架置入术的费用结构类指标具有显著性影响,建议医院充分考虑集采政策对临床科室的影响,不断优化病种费用结构,对相关临床科室的考核指标进行动态调整,同时加强临床路径的管理,提升治疗效率。Objective To investigate the impact of the centralized procurement policy on the performance evaluation of coronary stent implantation.Methods Data were collected from the patients who underwent coronary stent implantation and were discharged from the Department of Cardiology in a tertiary hospital in a city from January 2020 to December 2021.The Interrupted Time Series Analysis(ITSA)was conducted to evaluate the impact of centralized procurement policy in terms of efficiency and cost dimensions.Results The centralized procurement policy of coronary stents significantly influenced the average cost of coronary stenting,proportion of material cost,and proportion of medical service revenue,but had no significant impact on the number of cases and the average length of stay.Conclusion The centralized procurement policy of coronary stents has a significant impact on the cost structure index of coronary stent implantation.Therefore,it is recommended that hospitals fully consider its impact on clinical departments,continuously optimize the cost structure of diseases,and dynamically adjust the assessment indicators of relevant clinical departments.Additionally,it is also imperative to strengthen the management of clinical pathways and improve treatment efficiency.

关 键 词：冠脉支架集中带量采购 中断时间序列分析 绩效评价 

分 类 号：R197.322[医药卫生—卫生事业管理] R654.2[医药卫生—公共卫生与预防医学]