目的: 评估耗材集中采购政策对膝关节置换术患者费用的影响,分析费用变化规律,为合理控制该类手术费用提供证据。方法: 利用政策实施前后的真实世界数据,采用断点回归分析耗材集中采购对膝关节置换术患者住院费用的影响。结果: 耗材集中采购政策实施后,膝关节置换术患者的住院费用显著下降。最优带宽约为57.48天,在2022年4月30日,患者平均住院费用降低了23311.29元。在1/2最优带宽下,费用降低了24923.05元,而在2倍最优带宽下,费用降低了21547.30元。不同带宽下的局部平均效应略有差异,但总体呈现下降趋势。结论: 耗材集中采购政策有效降低了膝关节置换术患者的住院费用。建议医院管理者严格执行集采政策,完善临床路径标准化诊疗行为,进一步降低患者费用。此外,相关部门应稳步扩大集采范围和加强监管,确保政策的有效实施,从而提高患者对医疗服务的可及性和可负担性。
Abstract
Objective: The paper evaluates the effect of centralized medical consumables procurement policy on expenses of patients undergoing knee arthroplasty and analyzes the law of cost change, providing evidence for reasonably controlling the cost of these surgeries. Methods: Based on the real-world data before and after the implementation of policy, RDD was applied to analyze the impact of centralized medical consumables procurement on the hospitalization costs of patients undergoing knee arthroplasty. Results: After the implementation of centralized medical consumables procurement policy, the hospitalization costs of patients undergoing knee arthroplasty have significantly decreased. The optimal bandwidth was approximately 57.48 days, and the average hospital expenses of patients decreased by 23311.29 yuan on April 30, 2022. The estimated results of 1/2 optimal bandwidth showed that the expenses decreased by 24923.05 yuan, and the estimated results of 2 times optimal bandwidth showed that the expenses decreased by 21547.30 yuan. The local average effect of different bandwidths is slightly different, but all shows a decreasing trend. Conclusion: The centralized medical consumables procurement policy has effectively reduced the hospital expenses of patients undergoing knee arthroplasty. Hospital managers should strictly implement the procurement policy, improve clinical pathways and standardize diagnosis and treatment behavior to reduce patients’ expenses. In addition, relevant departments should steadily expand the scope of procurement and strengthen supervision to ensure the effective implementation of policy and improve the accessibility and affordability of medical services.
关键词
耗材集采政策 /
膝关节置换术 /
住院费用 /
断点回归
Key words
centralized medical consumables procurement policy /
knee arthroplasty /
hospitalization expenses /
RDD
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