医用耗材集中带量采购政策对医务人员临床使用决策的影响研究——以心脏支架、药物涂层球囊、冠脉导引导丝为例

Study on the Impact of the Centralized Volume-based Procurement Policy of Medical Consumables on the Clinical Use Decision of Medical Staff——Taking Cardiac Stents,Drug-coated Balloons and Coronary Guidewires as examples

目的:分析医用耗材集中带量采购(集采)政策对医务人员使用心脏支架、药物涂层球囊和冠脉导引导丝的影响。方法:基于S市医保结算系统2020—2023年数据,通过描述性统计、趋势分析以及t检验,评估集采政策对耗材使用量的影响。结果:集采政策实施后,心脏支架、药物涂层球囊和冠脉导引导丝的使用量均显著增加(P<0.05);DRG支付体系下,医务人员出于经济考虑更倾向于使用价格较高的药物涂层球囊。结论:集采政策改变了耗材使用格局,对医务人员临床决策具有一定影响;应建立政策动态反馈机制,推进临床路径标准化,加强内部监督与政府监管,深化薪酬制度改革,协同医疗服务价格改革,以优化资源配置、提升医疗服务质量,从而构建更加高效、公平、可持续的医疗服务体系。

Objective To analyze the impact of the centralized volume-based procurement policy of medical consumables on the use of cardiac stents,drug-coated balloons and coronary guidewires by medical staff.Methods Based on the data from the medical insurance settlement system in S city from 2020 to 2023,the impact of the centralized volume-based procurement policy on the consumption of medical consumables was assessed through descriptive statistics,trend analysis,and t-test.Results After the implementation of centralized volume-based procurement policy,the use of cardiac stents,drug-coated balloons and coronary guidewires increased significantly(P<0.05).Under the DRG payment system,medical staff preferred to use drug-coated balloons with higher prices for economic reasons.Conclusion The centralized volume-based procurement policy has changed the pattern of medical consumables use,and has certain influence on clinical decision-making of medical staff.It is necessary to establish a dynamic feedback mechanism for the policy,promote the standardization of clinical pathway,strengthen internal supervision and government regulation,deepen the reform of salary system,and coordinate the reform of medical service price,so as to optimize the allocation of medical resources and improve the quality of medical services.Thus,a more efficient,fair and sustainable medical service system can be established.