基于真实世界证据的聚氨酯材质PICC导管带量采购后临床应用评价研究  

Evaluation of Clinical Application of Polyurethane PICC Catheter After Volume-Based Procurement Based on Real-World Evidence

作　　者：刘伟 耿姣姣 杨文勇 邓刚 LIU Wei;GENG Jiaojiao;YANG Wenyong;DENG Gang(Material Supply Center,Affiliated Hospital of Hubei University of Arts and Science/Xiangyang Central Hospital,Xiangyang Hubei 441000,China)

机构地区：[1]湖北文理学院附属医院/襄阳市中心医院物资供应中心,湖北襄阳441000

出　　处：《中国医疗设备》2025年第3期120-125,共6页China Medical Devices

基　　金：国家卫健委医院管理研究所基于真实世界证据的聚氨酯材质PICC导管带量采购后临床应用评价研究(20230646)。

摘　　要：目的对比经外周静脉穿刺置入中心静脉导管(Peripherally Inserted Central Catheter,PICC)带量采购前后的临床使用情况及患者治疗费用,为优化临床决策、完善医用耗材带量采购政策提供参考。方法通过关键知情人访谈收集PICC带量采购前后的临床使用情况,基于文献回顾、关键知情人访谈等构建PICC整体费用模型,采用Kruskal-Wallis检验对患者整体治疗费用进行分析。结果通过护士访谈,带量后的PICC实际平均留置时间相较于带量前平均留置时间缩短10.77%、穿刺时间增加14.21%、置管后导致的并发症或不良反应发生率相对带量前均有不同程度的上升;PICC带量采购前后患者的住院费用、卫材费差异均有统计学意义(P<0.05)。带量采购后的PICC单价和均次置管总费用明显下降,但均次并发症费用呈上升趋势,差异均有统计学意义(P<0.05)。结论带量采购后,PICC的质量及临床使用情况并不十分理想。建议各医疗主体加强对医用耗材带量采购前、中、后的质量评估体系建设和临床使用监测,系统分析患者治疗费用,逐步建立针对医用耗材带量采购的质量和整体费用评价标准,进一步完善医用耗材带量采购体系。Objective To compare the clinical use and the cost of patient treatment before and after the volume-based procurement of peripherally inserted central catheter(PICC),to provide a reference for optimizing clinical decision-making and improving the policy of volume-based procurement for medical consumables.Methods The clinical use data of PICC before and after volumebased procurement was collected through interviews with key insiders.The overall cost model of PICC was constructed based on literature review and interviews with key insiders.Kruskal-Wallis test was used to analyze the overall treatment cost of patients.Results According to the interviews with nurses,the actual mean retention time of PICC after volume-based procurement was reduced by 10.77%,the puncture time was increased by 14.21%,and the incidence of complications or adverse reactions caused by catheterization after volume-based procurement was increased to varying degrees compared with that before the volume-based procurement.There were statistically significant differences in hospitalization cost and eisai cost before and after the volume-based procurement of PICC(P<0.05).The unit price of PICC and the total cost of average catheterization after volume-based procurement decreased significantly,but the average cost of complications after volume-based procurement showed an increasing trend,with all the differences were statistically significant(P<0.05).Conclusion The quality and clinical use of PICC were not very satisfactory after the volume-based procurement.It is suggested that all medical entities strengthen the construction of quality evaluation system and clinical use monitoring before,during and after the volume-based procurement of medical consumables,systematically analyze the treatment costs of patients,gradually establish the quality and overall cost evaluation standards for the volume-based procurement of medical consumables,and further improve the volume-based procurement system of medical consumables.

关 键 词：经外周静脉穿刺置入中心静脉导管 带量采购 成本分析 并发症发生率 医用耗材 治疗费用结构 

分 类 号：R197.3[医药卫生—卫生事业管理]