“数据驱动”促进高值医用耗材合理使用方法研究  

Research on data-driven methods to promote the rational use of high-value medical consumables

作　　者：谢世堂 韩优莉 赵万全[1] XIE Shitang;HAN Youli;ZHAO Wanquan(Beijing Tiantan Hospital,Capital Medical University,Beijing,100070,PRC)

机构地区：[1]首都医科大学附属北京天坛医院,北京市100070 [2]首都医科大学公共卫生学院,北京市100069

出　　处：《中国医院》2025年第4期73-76,共4页Chinese Hospitals

基　　金：国家自然科学基金项目(72174129);首都医科大学附属北京天坛医院院科研基金(管理专项)(TYGL202318)。

摘　　要：目的:探索高值医用耗材合理使用监测评价方法的改进。方法:定性方法,在案例医院常态开展临床调研,反馈耗材使用评价月度报告、倾听临床意见,积累方法改进一手资料。定量方法,通过单台手术高值耗材支出统计描述和双重差分回归评估改进效果。结果:基于科室调研在传统监测评价方法基础上改进形成“医院-科室-医生-术式(病种)-病例-耗材”六维关联监测方法,补充开展高额病例耗材合理使用临床分析评价方法;实现“职能高效监测聚焦”驱动临床科室发挥专业权威性,显著降低了重点术式高值耗材支出。医院经历“解冻-变革-冻结”3个阶段实现监测评价方法改进与常态化实施。结论:六维关联监测方法与高额病例耗材合理使用临床分析组合是有益改进与补充,结合耗材合理使用评价的目标管理方法,构成了“数据驱动”促进高值医用耗材合理使用的有效做法模式。Objective:To explore improvements in monitoring and evaluation methods for the rational use of high-value medical consumables.Methods:A qualitative approach was employed,involving continuous clinical research in a case hospital,regular feedback on monthly consumable usage evaluation reports,and collection of first-hand data for methodological improvements.A quantitative approach was applied through statistical description of high-value consumable expenditure per surgery and difference-in-differences(DID)regression analysis to assess the effectiveness of improvements.Results:Based on departmental research,a six-dimensional correlation monitoring method—linking hospital,department,physician,surgical procedure(disease type),case,and consumables—was developed as an improvement on traditional monitoring and evaluation methods.Additionally,a clinical analysis and evaluation method for high-cost case consumables was introduced.The“efficient monitoring and focus”strategy empowered clinical departments to exert their professional expertise,significantly reducing the expenditure on high-value consumables for key surgical procedures.The hospital underwent a"unfreeze-change-freeze"three-phase transition to implement and standardize the improved monitoring and evaluation methods.Conclusion:The six-dimensional correlation monitoring method,combined with clinical analysis of high-cost case consumables,serves as an effective enhancement.When integrated with target management strategies for evaluating consumable usage,this data-driven approach proves to be an effective model for promoting the rational use of high-value medical consumables.

关 键 词：医院 数据驱动 临床协同 医用耗材 合理使用 监测评价 

分 类 号：R197.3[医药卫生—卫生事业管理]