某医院冠脉支架集采前后经皮支架植入病组患者住院费用分析  

An Analysis of the Changes of Hospitalization Costs in Patients with Percutaneous Coronary Stent Implantation in a Certain Hospital before and after Coronary Stent Collection

作　　者：唐晋 俞岚[2] 杨艳霞 杞绍福 TANG Jin;YU Lan;YANG Yanxia;QI Shaofu(The First Clinical College of Kunming Medical University,Kunming,Yunnan,650000;Asset Management Department,The First Affiliated Hos-pital of Kunming Medical University,Kunming,Yunnan,650000;Pharmaceutical Price Bidding and Procurement Department,Yunnan Medical Security Bureau,Kunming,Yunnan,650000)

机构地区：[1]昆明医科大学第一临床学院,云南昆明650000 [2]昆明医科大学第一附属医院资产管理部,云南昆明650000 [3]云南省医疗保障局医药价格招标和采购处,云南昆明650000

出　　处：《江苏卫生事业管理》2025年第2期237-240,共4页Jiangsu Health System Management

基　　金：昆明医科大学研究生创新基金项目(2024S084)。

摘　　要：目的:通过分析某医院经皮冠状动脉支架植入病组(DRG分组FM19)患者在冠脉支架集中带量采购前后住院费用变化,从医保付费、耗材集采、供应商以及医院耗材管理的不同角度提出集采流程优化与实施策略。方法:采集该医院2020年冠脉支架集采前和2021年集采后患者的住院费用信息、冠脉支架使用情况以及医保报销情况进行统计分析。结果:该病组患者平均住院日呈下降趋势,住院总费用降低17.5%,次均耗材费降幅21.5%;集采前后例均支架费用降幅67.7%,球囊例均费用增幅6.8%,患者住院费用构成,耗材费、手术治疗费、检查费和服务费在集采前后差异有统计学意义(P <0.05)。结论:集采冠脉支架可有效降低患者住院费用,但耗占比在住院费用中仍然较高,须进一步细化DRG付费改革;扩大集采品类范围并加强耗材集采执行的监管;动态调整医疗服务价格;严格集采耗材供应商的资质管理;加强医院高值耗材的精细化管理。Objective:To analyze the changes of hospitalization costs of patients in the percutaneous coronary artery stent implantation group(DRG group FM19)in a certain hospital before and after the centralized procurement of coronary stents,and to propose the optimization of the centralized procurement process and the implementation of strategies from the perspectives of medical insurance payment,centralized procurement of consumables,suppliers and hospital consumables management.Methods:The hospitalization expense information,coronary stent use and medical insurance reimbursement of patients before and after coronary stent collection from January 2020 to December 2020 and from January 2021 to December 2021 were analyzed by statistical method in the hospital.Results:The average length of stay of patients in this group showed a downward trend,the total hospitalization cost decreased by 17.5%,and the average consumables cost decreased by 21.5%.The average cost of stents before and after centralized procurement decreased by 67.7%,and the average cost of balloon increased by 6.8%,and the composition of hospitalization expenses,consumables,surgical treatment costs,examination fees and service fees in this group was statistically significant before and after centralized procurement(P<0.05).Conclusion:Centralized procurement of coronary stents can effectively reduce the hospitalization cost of patients,but the proportion of hospitalization cost is still high,and the DRG payment reform should be further refined.expand the scope of centralized procurement categories and strengthen the supervision of the implementation of centralized procurement of consumables;dynamic adjustment of medical service prices;Strict qualification management of consumables suppliers;Strengthen the fine management of high-value consumables in hospitals.

关 键 词：疾病诊断相关分组(DRG) 冠脉支架 集中带量采购 住院费用 

分 类 号：R197.1[医药卫生—卫生事业管理]