腹腔镜下子宫肌瘤剔除术住院患者费用分析

Analysis on the Expense of Hospitalized Patients with Myomectomy under Laparoscope

目的通过研究腹腔镜下子宫肌瘤剔除术患者住院费用结构与手术耗材的变化,找出导致费用过快上涨的主要原因,为控制医疗费用过快增长提供依据。方法选取2012年-2015年上半年在某院行腹腔镜下子宫肌瘤剔除术的1019例患者的住院费用、手术耗材的资料,分析不同年份、不同医疗组间费用结构变化,手术耗材的变化。结果 2015年人均费用较2012年增长31%,耗材费用206%,其中手术耗材增长297%;不同医疗组间人均费用最高与最低相差9%,药费相差31%,耗材相差206%,其中手术耗材相差297%;不同年份、不同医疗组间药品,耗材使用等方面均有显著性差异,耗材增长是外科患者费用增长的主要因素。结论通过采取细化各种临床路径,限定耗材种类,规范医师耗材使用等多种措施可以降低患者耗材费用,减轻患者负担。

Objectives To find out the main reasons that caused the excessively fast improvement of hospitalized expense through analyzing on the changes of expenses structure and surgical consumables of hospitalized patients with myomectomy operations under laparoscope,and provide evidence to control the excessively fast improvement of medical expense. Methods The materials of hospitalized expense and surgical consumables of 1019 patients with myomectomy under laparoscope in the first half from 2012 to 2015 in a hospital were selected,the changes of the expense structure and surgical consumables in different years and groups were analyzed. Results From 2012 to 2015,the average expense of each person increased 31%,the consumables increased 206%,in which surgical consumables increased 297%. The highest average expense of each person was 9% more than the cheapest in different medical groups,the drugs expense was 31% and the consumables was 206%,in which surgical consumables increased 297%. There were significant difference in aspects including the utilization of drugs and consumables among different groups in different groups,the increase of consumables was the main factor of the increasing expenses among the surgical patients. Conclusions Through various of measures such as refining the clinical pathways,limiting the kinds of consumables as well as standardizing the utilization of the doctors,could we decrease the consumables expense and relieve the burden of the patients.