摘要
目的对比分析基于真实世界证据的冠脉支架集采前后的临床使用效果,为提高医院及科室管理水平提供参考。方法采取回顾性研究,收集集采政策实施前后患者病案数据,以2019年4月至2020年12月的447例为冠脉支架集采前组(带量前),2021年1月至2022年3月的281例为冠脉支架集采后组(带量后),比较两组基线资料(性别、年龄、住院时间)、住院费用及费用结构、耗材费用构成情况、不同年龄段支架使用数量和带量前后治疗效果。结果带量后住院总费用、耗材费用、支架费用均较带量前显著下降(P<0.05),除支架外总费用和除支架外材料费用则较带量前显著上升(P<0.05)。带量后冠脉支架费用在耗材费用中占比较带量前明显下降(P<0.05),带量后年龄≤65岁组患者支架使用数量明显高于带量前(P<0.05),180 d内再手术率明显低于带量前(P<0.05)。结论实施冠脉支架带量采购有助于降低患者费用负担,减少冠脉支架费用,降低180 d内再手术率,这对于提高医院成本管控水平和患者治疗效果有重要意义。
Objective To compare and analyze the effectiveness of clinical use of coronary stents before and after centralized volumebased procurement based on real-world evidence,to provide a reference for improving hospital and departmental management.Methods A retrospective study was taken to collect patient case data before and after the implementation of the centralized volumebased procurement policy.A total of 447 cases from April 2019 to December 2020 were selected as the pre-centralized volume-based procurement group(pre-group),and 281 cases from January 2021 to March 2022 were selected as the post-centralized volume based procurement group(post-group).The baseline data(gender,age,length of hospitalization),hospitalization cost and cost structure,cost composition of consumables,number of stents used in different age groups and treatment effect before and after banding were compared between the two groups.Results The total cost of hospitalization,the cost of consumables,and the cost of stents in the post-group all decreased significantly compared with the pre-group(P<0.05),while the total cost excluding stents and the cost of materials excluding stents in the post-group increased significantly compared with the pre-group(P<0.05).The cost of coronary stents as a percentage of the cost of consumables decreased significantly in the post-group compared with the pre-group(P<0.05),and the number of stents used in patients aged≤65 was significantly higher in the post-group compared with the pre-group(P<0.05),and the reoperation rate within 180 d was significantly lower than pre-group(P<0.05).Conclusion The implementation of coronary stent centralized volume-based procurement can help reduce the cost burden of patients,reduce the cost of coronary stents and reduce the rate of reoperation within 180,which is important to improve the level of cost control of hospitals and patient treatment results.
作者
梅国江
沈磊
向寰宇
MEI Guojiang;SHEN Lei;XIANG Huanyu(Office of Dean,Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of Purchasing,Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中国医疗设备》
2023年第10期126-130,共5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医疗器械临床使用评价项目(20210319)。
关键词
真实世界证据
冠脉支架
医用耗材
集中带量采购
耗材费用
real-world evidence
coronary stent
medical consumable
centralized volume-based procurement
consumable costs
