医耗联动对手术患者住院费影响分析

Analysis of the Impact of Medical Consumables Reform on the Hospitalization Costs of Patients

目的 通过比较医院优势学科改革开展前后的患者住院费用变化,探索医耗联动政策实际产生的影响。方法 收集北京市某医院2018年6月15日至2020年6月15日期间1695例进行原发性单侧膝关节病全膝关节表面置换术的住院患者住院病案首页资料,根据医耗联动改革时间分为改革前和改革后两组,其中改革前914例,改革后781例。采用曼-惠特尼U检验和χ^(2)检验进行组间差异分析,多元线性回归分析医耗联动与住院费用改变之间的独立相关性。结果 医耗联动前后,住院总费用降低了2.44%,检查检验费下降13.66%、例均药品费下降4.32%、材料费下降4.71%,其他费用下降1.06%,治疗费增加58.13%,差异均具有统计学意义(p<0.05)。多元线性回归调整多个相关因素后发现医耗联动改革与住院费用的改变存在独立相关性。结论 医耗联动改革后,住院费用结构更加优化,医疗技术服务价值得到进一步体现,与改革预期和国家改革目标相符。

Objectives This study compared the changes of patients’ hospitalization costs before and after the implementation of the medical consumables reform in the hospital, to analyze the impact of the policy of medical expenditure. Methods A total of 1695 patients who were performed primary unilateral total knee arthroplasty in a hospital in Beijing between June 15th, 2018 and June 15th, 2020were involved in this study. All patients were divided into two groups according to the medical consumption reform. There were 914 cases before the reform and 781 cases after the reform. Mann-Whitney U test, Chi test and multiple linear regression were performed using SPSS26.0.Results Before and after the linkage of medical consumption, the total cost of hospitalization decreased by 2.44%, the cost of examination and examination decreased by 13.66%, the cost of drugs decreased by 4.32%, the cost of materials decreased by 4.71%, other costs decreased by 1.06%, and the cost of treatment increased by 58.13%, all the differences were statistically significant(p<0.05)The medical consumables reform was independently associated with the change of hospitalization coasts. Conclusions After the coordinated reform of medical consumption, the structure of hospitalization expenses had been optimized, and the value of medical technical services had been further reflected, which was in line with the reform expectations and national reform goals.