基于真实世界数据的止血材料使用评价研究  

Research on Evaluation of Hemostatic Material Use Based on Real World Data

作　　者：颜芬芬 韩宝江 王道雄[1] YAN Fenfen;HAN Baojiang;WANG Daoxiong(Department of Medical Equipment,Tongji Hospital of Tongji Medical College of Hust,Huazhong University of Science and Technology,Wuhan Hubei 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院器材科,湖北武汉430030

出　　处：《中国医疗设备》2023年第12期131-136,共6页China Medical Devices

基　　金：国家卫生健康委基金项目(2022MEB210)。

摘　　要：目的 基于真实世界数据,分析疾病诊断相关分组(Diagnosis Related Groups,DRG)一段时间内的患者止血材料费用,为开展该类耗材的管控提供支撑。方法 选取H医院病案数据中2022年1—10月的某个DRG组的数据,采用Spearman、Mann-Whitney U、Kruskal-Wallis统计方法,分析该DRG组下不同术式、不同科室患者止血材料使用情况,以及使用不同类别止血材料在费用效果及临床效果方面的差异。结果 患者止血材料费用与住院费用呈正相关。不同手术类型,止血材料费用存在差异;在选取的重点手术中,有4种手术两个科室止血材料费用存在差异,有两种手术不同诊疗组止血材料费用存在差异。该DRG组下6种手术对应患者均次费用与单价最低以及最高的两种止血材料使用率相关;使用单价最高的止血材料与使用其他类别止血材料相比,在费用效果方面,部分手术人均住院费用更高,且患者住院费用差异有统计学意义,在临床效果方面无差异。结论 本研究明确了管控该类耗材应重点关注的科室、术式、诊疗组以及产品种类,并从多个维度提出管理建议,对规范化临床用耗行为、精细化管控止血材料有借鉴意义。Objective Based on real world data,to analyze the cost of hemostatic materials for patients in diagnosis related groups(DRG)in a hospital over a period of time,to support for the management and control of such consumables.Methods The data from a certain DRG group in the medical record data of H hospital from January to October 2022 was selected,and Spearman,Mann Whitney U,and Kruskal-Wallis statistical methods were used to analyze the use of hemostatic materials in patients with different surgical procedures and departments under this DRG group,as well as the differences in cost effectiveness and clinical efficacy of using different types of hemostatic materials.Results The cost of hemostatic materials was positively correlated with hospitalization cost.The cost of hemostatic materials varied with different surgical types.In the selected key operations,there were differences in the cost of hemostatic materials between the two departments of four kinds of operations,and differences in the cost of hemostatic materials between different diagnosis and treatment groups of two kinds of operations.The average cost of the six kinds of operations in the DRG group was related to the utilization rate of the two hemostatic materials with the lowest unit price and the highest.Compared with other hemostatic materials with the highest unit price,in terms of cost effect,the per capita hospitalization cost was higher in some surgeries,and the difference in hospitalization cost was statistically significant,but there was no difference in clinical effect.Conclusion The departments,operation methods,diagnosis and treatment groups and product categories that should be focused on for the control of such consumables are clarified.In addition,according to the research results,management suggestions is proposed from multiple dimensions,which can be used for reference to standardize clinical consumption behavior and fine control of hemostatic materials.

关 键 词：真实世界 疾病诊断相关分组 止血材料 医用耗材 精细化管理 

分 类 号：R197.32[医药卫生—卫生事业管理]