基于临床路径的农村贫困人口儿童室间隔缺损救治的付费标准制订研究

Study on the Payment Criteria for the Treatment of Ventricular Septal Defect among Rural Poor Children Based on Clinical Pathway

目的:基于临床路径确定区域内贫困人口儿童先天性心脏病室间隔缺损救治的费用的支付标准,切实缓解因病致贫和因病返贫。方法:专家制订病种临床路径,依据临床路径对搜集的病历进行筛选,采用统计学方法,分析并确定病种救治费用的付费标准。结果:采用室间隔缺损修补术治疗儿童先天性心脏病室间隔缺损的支付标准为27 784元/例、拟定区间为(207 705,27 862),采用室间隔缺损封堵术治疗儿童先天性心脏病室间隔缺损的支付标准为28 702元/例、拟定区间为(28 405,29 000)。结论:儿童先天性心脏病室间隔缺损临床路径的开展仍需加强;科学的病种付费标准的实施能够助推微创手术(儿童室间隔缺损封堵术)的推广。

Objective: Based on the clinical pathway, to determine the payment criteria of congenital-heart-disease with ventricular septal defect in children, and to effectively alleviate poverty or the return of poverty due to illness. Methods: It screened the collected medical records according to the clinical path which the experts developed;used statistical methods to analyze and determined the payment criteria for payment of disease treatment. Results: The payment criteria for ventricular septal defect repair in children was 27 784 yuan/case, and the proposed interval was (207705, 27862). The payment criteria for closure of ventricular septal defect in children was 28 702 yuan/case, the proposed interval was (28405, 29000). Conclusion: The clinical pathway of children with congenital ventricular septal defect still needed to be strengthened. The implementation of scientific disease payment criteria could promote the promotion of minimally invasive surgery (closure of ventricular septal defect in children).