同种手术植入材料临床使用差异分析

Analysis of Clinical Use Differences of the Same Surgical Implant Materials

目的 通过对同种手术植(置)入材料在临床使用中的差异分析,探索其存在的主要问题,为建立医院植(置)入材料全过程规范化管理系统提供依据。方法 选取某大型综合性医院HIS系统2018年全年行“白内障囊外摘除+人工晶状体植入术”患者资料,参照《全国医疗服务价格项目规范(2012年版)》中对植(置)入材料的使用规范,应用方差分析法对不同医师、不同患者人工晶体使用情况进行差异分析。结果 ①人工晶体规格型号多,国别、供应商各异,价格差异大;②相同诊断、手术操作患者间人工晶体临床使用费用存在差异(P<0.05);③不同医师主要使用的人工晶体规格不同,次均费用存在差异(P<0.05)。结论 从医师、患者等角度分析植(置)入材料在临床中的使用差异,植(置)入材料的使用与医疗质量、医疗成本紧密关联,因此建立规范化、精细化、信息化的医院植(置)入材料管理体系尤为重要。

Objective Through the analysis of the differences in the clinical use of the same kind of surgically implant materials,exploring the main problems,and provide a basis for establishing a standardized management system for the whole process of implant materials.Methods Select the diagnosis and treatment data of a large-scale general hospital HIS system from July 2017 to June 2018 for“IOL implantation”,refer to the material use specification in the National Medical Service Price Project Specification(2012 Edition).Variance analysis method was used to analyze the difference between the use of implant materials in different doctors and patients.Select a large comprehensive hospital HIS system from July 2017 to June 2018,“Cataract extraction+IOL implantation”patient data,refer to the implant material use specification inthe"National Medical Service Price Project Specification(2012 Edition)",and the variance analysis method was used to analyze the difference of the use of intraocular lens by different doctors and patients.Results ①The same kind of implant materials vary in size,country,and supplier,and the price difference is large;②There is a difference in the clinical use cost of intraocular lens between different patients(P<0.05);③There is a difference in the average cost of clinical use of intraocular lens between the doctors(P<0.05).Conclusion Implant materials is important medical material that affects medical quality and medical costs.From the perspectives of doctors,patients,and materials,it’s found that there are large diversity in clinical use,so the establishment of standardized,refined,and information-based hospital material management system is imminent.