目的: 分析河南省Z医院冠脉支架集中采购前后经皮冠状动脉介入治疗患者的医疗费用,揭示冠脉支架集中采购落地执行效果及问题,并提出可行性建议,为后续耗材集中采购发展及医疗改革发展提供参考。方法: 通过文献分析法、描述性分析法等方法对冠脉支架集中采购情况、集采前后费用变化情况进行了深入分析。结果: 通过比较耗材集中采购政策的实施对药品费用、耗材费用、治疗费用及其他、住院总费用的影响,发现冠脉支架集中采购政策对降低患者医疗费用效果显著。但集采结果执行过程中存在信息不对称、部分耗材使用量上升及医生收治患者动力不强等问题。结论: 建议通过减少信息不对称、做好医疗服务补偿、建立科学的绩效考核体系及温和、全品类集中采购等方式,推动集中采购及医疗改革深入发展。

This article analyzes the medical expenses of patients undergoing percutaneous coronary intervention before and after centralized procurement of coronary stents at Z Hospital in Henan Province, reveals the implementation effect and problems of centralized procurement of coronary stents, and proposes feasible suggestions, providing reference for the development of centralized procurement of consumables and medical reform in the future. Method: A comprehensive analysis was conducted on the centralized procurement of coronary stents and the changes in costs before and after centralized procurement using methods such as literature analysis and descriptive analysis. Result: By comparing the impact of the implementation of the centralized procurement policy for consumables on drug costs, consumables costs, treatment costs and other fees, and total hospitalization costs, it was found that the centralized procurement policy for coronary stents had a significant effect on reducing patient costs. However, there are problems such as information asymmetry, increased use of some consumables, and weak motivation of doctors to treat patients during the implementation of centralized procurement results. Suggestions: It is recommended to advance centralized procurement and healthcare reform by reducing information asymmetry, properly compensating medical services, establishing a scientific performance evaluation system, and implementing a moderate, comprehensive centralized procurement model.