DIP付费下医用耗材集采对白内障手术患者的影响研究

Study on the Impact of Centralized Procurement of Medical Consumables under DIP Pay⁃ment on Cataract Surgery Patients

目的:探讨医用耗材集采的实施效果及政策优化措施,推进集采政策与DIP协同发展。方法:采用断点回归设计,比较2018-2022年样本医院人工晶体集采前后,白内障手术患者总费用及各细分费用的变化情况。结果:医用耗材集采显著降低了白内障手术患者的总费用(-1 063.13元)、耗材费(-1 055.98元)、耗材比(-8.9%)、自付费用(-1 176.26元),其中手术用一次性医用耗材降幅最为明显。结论:医用耗材集采一定程度上减轻了白内障手术患者的疾病负担,但耗材占比仍较高,费用结构有待优化。建议完善耗材临床应用管理、动态调整集采耗材分值、完善辅助目录,协同推进DIP改革。

Objective:To explore the implementation effect and policy optimization measures of centralized procurement of medical consumables,and to promote the coordinated development of centralized procurement policy and DIP.Methods:The breakpoint regres-sion design was used to compare the changes of the total cost of cataract surgery patients and the cost of each subdivision before and af-ter the centralized collection of intraocular lenses in the sample hospitals from 2018 to 2022.Results:The centralized procurement of medical consumables significantly reduced the total cost(-1063.13 yuan),consumables cost(-1055.98 yuan),consumables ratio(-8.9%)and out-of-pocket expenses(-1176.26 yuan)of cataract surgery patients,among which the reduction of disposable medical con-sumables for surgery was the most obvious.Conclusions and Suggestions:The centralized procurement of medical consumables has reduced the disease burden of cataract surgery patients to a certain extent,but the proportion of consumables is still high,and the cost structure needs to be optimized.It is recommended to improve the management of clinical application of consumables,dynamically adjust the score of centralized procurement consumables,improve the auxiliary catalog,and promote the DIP reform in a coordinated manner.