植入式静脉输液港操作成本核算研究

Cost-accounting for insertion,maintenance and removal of implanted vascular access ports

目的对植入式静脉输液港置管、维护及拔管的单项操作成本进行核算,为卫生行政部门制定合理的操作收费价格提供参考。方法采用项目成本阶梯分摊法,测算植入式静脉输液港各单项操作人力成本、设备折旧费及未单独计价材料费,测算直接成本,并通过分摊测算间接成本,最后测算其置管、维护及拔管的单项操作成本。结果植入式静脉输液港置管、维护及拔管各单项操作成本分别为(1186.93±37.33)元、(55.03±1.54)元、(850.25±57.77)元,高于上海市医疗机构植入式静脉输液港各项操作的收费标准。结论植入式静脉输液港置管、维护及拔管各单项操作成本未能体现医疗护理服务的投入与价值补偿。建议调整植入式静脉输液港置管、维护及拔管的收费标准,并将维护操作收费纳入收费标准中,促进该技术可持续发展及服务的持续供给。

Objective To account the operation costs for insertion,maintenance and removal of implanted vascular access ports,and to provide references for healthcare administration to set appropriate prices of the technique.Methods A step allocation method of project cost was adopted to measure the operation cost for insertion,maintenance and removal of implanted vascular access ports:the direct costs were measured by labor costs,material costs and equipment depreciation costs,and indirect costs were measured by allocation of direct costs;then the cost for each step(insertion,maintenance and removal)were calculated.Results The operation costs for insertion,maintenance and removal of implanted vascular access ports were￥(1186.93±37.33),￥(55.03±1.54),￥(850.25±57.77)respectively,which were much higher than the current pricing standards adopted by hospitals in Shanghai.Conclusion The current pricing standards for insertion,maintenance and removal of implanted vascular access ports fail to embody investment in medical-nursing services and fail to scoop back value compensation.It is recommended that the pricing stan-dards should be adjusted and charging for maintenance of implanted vascular access ports be included into current charging system based on the operation costs,in order to promote continuous development and supply of port services.