基于中断时间序列分析的江苏省某三甲综合医院冠脉支架集中带量采购政策实施效果研究  

Study on the Implementation Effect of Centralized Volume-Based Procurement of Coronary Stents in A Tertiary Comprehensive Hospital in Jiangsu Province Based on Interrupted Time-Series Analysis

作　　者：唐艳艳 王雪梅 胡蓉蓉 范思宇 徐娟[3] 周迎宏[1] Tang Yanyan(Zhongda Hospital Southeast University,Nanjing,P.R.China)

机构地区：[1]东南大学附属中大医院,江苏南京210009 [2]南京大学医学院附属鼓楼医院 [3]华中科技大学同济医学院医药卫生管理学院

出　　处：《中国卫生事业管理》2024年第4期384-389,共6页Chinese Health Service Management

基　　金：国家自然科学基金青年科学基金项目“医疗意见领袖在社区慢性病管理中的介入模式和效果评估”(71303084);南京大学中国医院改革发展研究院课题项目“DRG/DIP付费改革对创新医疗器械应用的影响及相互促进机制研究”(NDYG2023018);江苏省双创博士人才项目“公立医院医生抗菌药物处方决策的偏好异质性及模式研究-基于离散选择实验及潜在类别分析”(JSSCBS20221873)。

摘　　要：目的:通过分析江苏省某三甲综合医院冠脉支架集中带量采购政策实施前后的冠脉支架使用情况,评估冠脉支架集中带量采购政策实施效果,为冠脉支架集中带量采购政策协议期满后接续采购的持续优化及完善提供建议。方法:提取2018年10月~2022年10月江苏省某三甲综合医院冠脉支架使用量数据,采用中断时间序列分析方法分析江苏省冠脉支架集中带量采购政策和国家组织冠脉支架集中带量采购政策对江苏省某三甲综合医院冠脉支架使用数量的影响,同时分析该院实施冠脉支架集中带量采购政策前后的进口和国产冠脉支架使用情况。结果:江苏省冠脉支架集中带量采购政策执行后,冠脉支架使用量呈显著上升趋势(β_(3)=4.62,P=0.017);国家组织冠脉支架集中带量采购政策执行后,冠脉支架使用量的水平变化和趋势变化均不显著。江苏省冠脉支架集中带量采购政策实施后,国产冠脉支架和进口冠脉支架使用量都呈不显著上升趋势(β_(3)=2.46,P=0.232;β_(3)=2.16,P=0.173);国家组织冠脉支架集中带量采购政策实施后,国产冠脉支架使用量无显著变化(β_(5)=-1.09,P=0.589),进口冠脉支架使用量瞬间下降(β_(4)=-46.6,P=0.018),随后呈上升趋势,但变化不显著(β_(5)=0.16,P=0.919)。结论:该院总体上冠脉支架集中带量采购政策实施效果良好,江苏省冠脉支架集中带量采购政策实施后增加了该院冠脉支架使用量;国家组织冠脉支架集中带量采购政策促使该院冠脉支架使用量稳中有涨,其中国产冠脉支架整体呈上升趋势,进口冠脉支架使用量整体下降。后续国家冠脉支架集中带量采购政策建议探索多元化的分配方式,合理分配国产冠脉支架和进口冠脉支架中选品种,规范冠脉支架合理使用。Objective To analyze the usage of coronary stents before and after the implementation of centralized procurement policy for coronary stents in a tertiary comprehensive hospital in Jiangsu Province,evaluate the implementation effect of the policy,and provide suggestions for the continuous optimization and improvement of procurement after the expiration of the centralized procurement agreement for coronary stents.Methods Data of the consumption of coronary stents in a tertiary comprehensive hospital in Jiangsu Province from October 2018 to October 2022 were extracted,and analyzed by using the Interrupted Time Series Analysis.Results After the implementation of the centralized procurement policy for coronary stents in Jiangsu Province,the amount of usage of coronary stents showed a significant upward trend(β_(3)=4.62,P=0.017).After the implementation of the national policy of centralized procurement of coronary stents,the level and trend changes in the use of coronary stents were not significant.After the implementation of the centralized procurement policy for coronary stents in Jiangsu Province,the usage of domestic and imported coronary stents showed a insignificantly upward trend(β_(3)=2.46,P=0.232;β_(3)=2.16,P=0.173).After the implementation of the national policy of centralized procurement of coronary stents,there was no significant change in the use of domestic coronary stents(β_(5)=-1.09,P=0.589),while the use of imported coronary stents immediately decreased(β_(4)=-46.6,P=0.018),followed by an upward trend,which was not significant(β_(5)=0.16,P=0.919).Conclusion The overall implementation effect of the centralized procurement policy for coronary stents in this hospital achieved good results.The implementation of the centralized procurement policy for coronary stents in Jiangsu Province has increased the use of coronary stents in the hospital.The policy of centralized procurement of coronary stents by national organizations has led to a steady increase in the use of coronary stents in hospitals,in whic

关 键 词：冠脉支架 集中带量采购 中断时间序列分析 

分 类 号：R197.39[医药卫生—卫生事业管理]