基于疾病诊断相关分组的医用耗材供应目录动态调整管理研究  

Study on the management of dynamic adjustment for supply catalogue of medical consumables based on DRG

作　　者：华婷[1] 沈云明[1] 苏畅[1] 鲍莉 孟羽飞 张林灵 郑焜[1] Hua Ting;Shen Yunming;Su Chang;Bao Li;Meng Yufei;Zhang Linling;Zheng Kun(Department of Medical Equipment,Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health and Disorders,HangZhou 310052,China)

机构地区：[1]国家儿童健康与疾病临床医学研究中心,浙江大学医学院附属儿童医院医疗设备部,杭州310052

出　　处：《中国医学装备》2025年第2期143-147,共5页China Medical Equipment

基　　金：浙江省卫生健康科技计划(2022PY068)。

摘　　要：目的:探索基于疾病诊断相关分组(DRG)构建医用耗材供应目录动态调整管理体系,以实现医用耗材合理合规使用的精细化监管。方法:分析医用耗材管理现存问题,从制度建立、分级管理、细化分类、公告管理、强化试用和规范合同6个维度构建医用耗材供应目录动态调整管理体系。选取2022年1月至2023年12月浙江大学医学院附属儿童医院临床在用的149大类医用耗材,采用医用耗材供应目录动态调整管理体系对医用耗材供应调整前后的卫生材料收入占医疗收入比例和卫生材料费用占医疗总费用比例变化情况进行对比。结果:动态调整后,149大类医用耗材根据试用流程有32大类(占21.48%)进行了调整;根据分类目录有14大类(占9.40%)进行了二级目录优化,有85大类(占57.05%)缩减了产品品牌,有8大类(占5.37%)涉及停用处理。2023年在门急诊人次和出院人次均增加的前提下卫生材料收入占医疗收入比例由2022年的8.02%降至7.29%,卫生材料费用占医疗总费用比例由2022年的15.38%降至14.17%,累计降低医用耗材成本737万元,占医用耗材支出的4.1%。2022年和2023年医用耗材的线上采购率分别为93.05%和94.34%,呈上升趋势。结论:医用耗材供应目录动态调整管理体系应用能够降低医院耗占比,提高医用耗材管理效率,降低医用耗材采购费用。Objective:To explore the construction of management system of dynamic adjustment for supply catalogue of medical consumables based on diagnosis related groups(DRG),so as to realize the fine supervision and management of rational and compliant use for medical consumables.Methods:The management system of dynamic adjustment for supply catalogue of medical consumables was constructed from 6 dimensions(system establishment,hierarchical management,detailed classification,announcement management,strengthening trial and standardizing contract)through analyzed the existing problems.A total of 149 broad headings of using medical consumables in clinical work of Children's Hospital,Zhejiang University School of Medicine from January 2022 to December 2023 were selected.The changes of the ratio of hygienic material's income in medical income,and the ratio of hygienic material's cost in medically overall cost were compared between before adopted the management system of dynamic adjustment for supply catalogue of medical consumables(2022)and after adopted that(2023).Results:After dynamic adjustment,32 broad headings(21.48%)of 149 broad headings of medical consumables were adjusted according to trial process,and 14 broad headings(9.40%)of medical consumables were optimized in the secondary catalogue,and 85 broad headings(57.05%)of medical consumables reduced their product brand,and the use of 8(5.37%)broad headings of medical consumables were stopped.On the premise that both the person-time of outpatient and emergency,and the person-time of discharge increased,the ratio of the income of hygienic material in medical income decreased from 8.02%of 2022 to 7.29%of 2023,and the ratio of hygienic material cost in overall medical cost decreased from 15.38%of 2022 to 14.17%of 2023,and the accumulated cost of medical consumables was reduced by 7.37 million CNY,accounting for 4.1%of the expenditure of medical consumables.Online procurement rates of medical consumables were respectively 93.05%and 94.34%in 2022 and 2023,which showed an incre

关 键 词：疾病诊断相关分组(DRG) 医用耗材 供应目录 动态调整 耗占比 

分 类 号：R197.39[医药卫生—卫生事业管理]