2016-2022年我国日间手术术式变化及对日间手术规范化发展的思考

Considerations of the standardized development of day surgery in China based on the changes of day surgery from 2016 to 2022

目的:分析2016-2022年国家发布的日间手术术式变化状况,思考促进日间手术健康发展的关键要素。方法:利用国家卫生健康委公布的《日间手术推荐目录(2022年版)》对2016年、2019年、2022年3个阶段日间手术术式变化情况进行统计分析。结果:2016-2022年,日间手术推荐术式个数增加了7.85倍,日间手术术式占总术式比例从0.59%上升到5.19%,专业分布从8个专业增加到14个专业,各专业日间手术术式呈现线性增加趋势,各专业手术级别构成也发生了变化。结论:日间手术在快速发展阶段稳健发展需要依靠一个评价体系,3个层面发力。一个体系是指需要探讨建立日间手术质量与安全管理评价体系,保障日间手术的质量与安全。三个层面:一是要从宏观层面探讨医保政策衔接、优化日间手术医疗费用结构等方面激励医疗机构开展日间手术,提升日间手术服务的可及性;二是从中观层面不断探索日间手术管理机制研究,保障其科学化发展;三是微观层面创新服务技术、服务流程、管理模式不断提升日间手术管理效率,提高患者的满意度和就医获得感。

Objective:This paper analyzed the changes in surgical approaches to day surgery issued by the state from 2016 to 2022,and considered the key factors to promote the healthy development of day surgery.Methods:The changes in surgical approaches to day surgery in 2016,2019 and 2022 were statistically analyzed by using the recommended catalog of day surgery(2022 Edition)published by the National Health Commission.Results:From 2016 to 2022,the number of recommended surgical approaches for day surgery in China increased by 7.85 times,the proportion of surgical approaches for day surgery in total approaches increased from 0.59%to 5.19%,and the number of specialties increased from 8 to 14.The surgical approaches for day surgery in each specialty showed a linear increase trend,and the proportion of Surgical grade of each specialty has also changed.Conclusion:In the stage of rapid development of day surgery in China,the steady development of day surgery needs to rely on an evaluation system and three levels of effort.One system refers to the need to explore the establishment of quality and safety management evaluation system to ensure the quality and safety of day surgery.Three levels:The first is to explore the convergence of medical insurance policy and optimize the medical cost structure of day surgery from the macro level to encourage hospitals to carry out day surgery,so as to improve the accessibility of day surgery services;The second is to constantly explore the management mechanism of day surgery from the meso level to ensure its scientific development;The third is to innovate service technology,service process,management model at the micro level,so as to continuously improve the management efficiency of day surgery,and improve patients’satisfaction and sense of access to medical treatment.